Clinical Efficacy And Safety Of Roxadustat In The Treatment Of Renal Anemia With Low Erythropoietin Response In Maintenance Hemodialysis Patients

Objective:To observe the efficacy and safety of roxadustat in the treatment of renal anemia with low erythropoietin(EPO)response in maintenance hemodialysis(MHD)patients.Methods:This study included 42 patients with maintenance hemodialysis renal anemia from three tertiary hospitals from Taiyuan from September 2019 to June 2021,all of whom had low erythropoietin response,and were switched to oral roxadustat for 24 weeks.The levels of hemoglobin were observed before treatment and the 2nd,4th,8th,12 th,and24th weeks after treatment,the compliance rate of Hb and the rate of roxadustat reaction were calculated.The iron metabolism indexes,lipid metabolism indexes,biochemical indexes and blood pressure were observed before treatment and the 12 th and 24 th weeks after treatment.The occurrence of adverse reactions during the treatment period was collected.Results:Forty-two low erythropoietin response patients treated with roxadustat,with an average age of(49 ± 13)years and a dialysis age of(36.88 ± 30.44)months,the underlying causes mainly included chronic glomerulonephritis with 22 cases(52.38%)and diabetic nephropathy with 10 cases(23.81%).The baseline(average level before treatment)hemoglobin was(85.85±11.14)g/L,and the average hemoglobin levels at the2 nd,4th,8th,12 th,and 24 th weeks of treatment were significantly higher than those before treatment(P<0.001).After 24 weeks of treatment,the hemoglobin compliance rate was 83.33%(35 cases),and the response rate of roxadustat was 92.86%(39 cases).The dose adjustment process of roxadustat was first reduced and then increased.There was no significant difference in the mean hemoglobin levels before and after treatment between the normal C-reactive protein group and the elevated C-reactive protein group(P>0.05).After 12 ～ 24 weeks of roxadustat,hematocrit,mean corpuscular volume,mean corpuscular hemoglobin,serum iron,and total iron binding capacity increased,serum ferritin and low-density lipoprotein declined.All patients had no serious adverse events.Conclusion:Roxadustat is not susceptible to inflammation,it can improve iron metabolism and reduce blood lipids,increase hemoglobin level safely and effectively in maintenance hemodialysis patients with low erythropoietin response.