Objective:The Study delves into the clinical efficacy of Roxadustat for treatment of erythropoietin (EPO) hyporesponsive anemia in hemodialysis (HD) patients.
Methodology:A retrospective analysis was performed on 22 patients who had received HD treatment from May 2020 to February 2021. All patients had EPO hyporesponsive anemia, continued treatment with erythropoietin (EPO) for 3 months at a maximum dose≥300 IU/kg/week, but failed to raise hemoglobin levels above 100 g/L. The changes of hemoglobin and iron metabolism were monitored after conversion to roxadllstat.To observe the efficacy of Roxadustat in the treatment of ESA hyporesponsive anemia.
Results:Twentytwo hemodialysis patients (12 males and 10 females) were enrolled, age was 55±16 years old, dry weight was 627±124 kg and duration of dialysis was 102(38,163) months. Baseline hemoglobin was 811±103 g/L at the mean dose of EPO 12 272±2 979 units therapy per week. 4 patients (182%) had transferrin saturation less than 20%, 8 patients (364%) had serum ferritin less than 200 μg/L, and EPO antibody was all negative.The average dose of Roxadustat was 1064±95 mg. After 1, 2 and 3 months of treatment, hemoglobin increased significantly from baseline to 1020±169 g/L, 1027±168 g/L and 1059±161 g/L, respectively (all P<0001).seventeen patients (772%) had higher hemoglobin than 110g/L.Anemia did not improve in 5 patients (227%), the underlying diseases were systemic lupus erythematosus (n=3) or ANCAassociated vasculitis (n=1), 1 patient with transplanted kidney failure was infected with parvovirus.Compared to baseline,total ironbinding capacity increased (478±145 μmol/L vs 397±99 μmol/L, P=0004), while the serum iron, transferrin saturation and serum ferritin had no significant changes. Creactive protein decreased [36 (15, 56) mg/L vs 59 (24, 93) mg/L, P=0041], and serum potassium increased (521±077 mmol/L vs 472±100 mmol/L, P=0033).
Conclusion:Roxadustat is effective for treatment of ESA hyporesponsivenessrelated anemia in patients undergoing hemodialysis.