Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2022, Vol. 31 ›› Issue (1): 9-14.DOI: 10.3969/j.issn.1006-298X.2022.01.002
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Abstract: Objective:To compare the influence of roxadustat and recombinant human erythropoietin (rHuEPO) on blood pressure, cardiovascular parameters, cardiocerebrovascular complications in renal anemia patients undergoing peritoneal dialysis (PD). Methodology:Fifty PD patients who were treated with roxadustat via oral administration for renal anemia in PD center of National Clinical Research Center of Kidney Diseases recruited from June 2019 to April 2020 as roxadustat group were retrospectively analyzed. PD patients who were treated with rHuEPO via subcutaneous injection were randomly enrolled in a 1∶1 ratio as rHuEPO group. Hemoglobin, blood pressure, cardiovascular parameters, cardiocerebrovascular complications were compared between the two groups before and after treatment. All patients were followed up for at least 18 months. Results:There were no significant differences in baseline clinical data and laboratory values between roxadustat group and rHuEPO group. After 18 months of followup, Hb in both groups was significantly increased compared with the baseline, and there was no statistical difference in Hb levels between the two groups after followup (P>005). There were no significant changes in systolic and diastolic blood pressure, the incidence of nocturnal hypertension before and after treatment in roxadustat group (P>005), while systolic and diastolic blood pressure were significantly increased in rHuEPO group after treatment, the incidence of nocturnal hypertension increased(P<005). There were no significant differences in cardiovascular parameters in roxadustat group before and after treatment (P>005). After followup, the levels of aminoterminal probrain natriuretic peptide (NTproBNP), troponin T (TnT), troponin I (TnI), cardiothoracic ratio in rHuEPO group increased, left ventricular ejection fraction (LVEF) decreased, and cardiocerebrovascular complications increased (P<005). Compared with roxadustat group after followup, rHuEPO group had higher incidence of nocturnal hypertension, and the levels of NTproBNP, TnT, TnI and cardiothoracic ratio were higher, LVEF had a lower level, cardiocerebrovascular complications had a higher incidence (P<005). Multivariate COX regression analysis showed that fasting blood glucose and rHuEPO used before at baseline were impendent risk factors for cardiocerebrovascular complications in PD patients, and treatment of roxadustat had independent protective effect on cardiocerebrovascular complications (hazard ratio 0208, 95%CI 0057~0761, P=0018). Conclusion:Compared with rHuEPO, roxadustat had less influence on blood pressure or cardiovascular parameters, and had a lower risk of cardiocerebrovascular complications in patients undergoing peritoneal dialysis. It has significant cardiocerebrovascular protective advantages in peritoneal dialysis patients with renal anemia.
Key words: Roxadustat,recombinant human erythropoietin,peritoneal dialysis,blood pressure,cardio-cerebrovascular complications
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URL: http://www.njcndt.com/EN/10.3969/j.issn.1006-298X.2022.01.002
http://www.njcndt.com/EN/Y2022/V31/I1/9