Explore The Effect Of HIF-PHI On Blood Pressure Variation Rate And Anemia Efficacy In Maintenance Hemodialysis Patients

Objective: To explore the effect of HIF-PHI(hypoxia-inducing factor prolyl hydroxylase inhibitor Roxadustat)on blood pressure variability,blood pressure index,hemoglobin and other biochemical indices in Maintenance hemodialysis(MHD)patients.Method: In a retrospective self-controlled study,regular hemodialysis treatment and regular use of rosalsitat for ≥6 months were performed in the hemodialysis room of the First Affiliated Hospital of Nanchang University from June 2019 to November2022.MHD patients who regularly use Erythropoiesis Stimulating Agent ESA for ≥6months before using rosalstat are the study objects.Blood pressure data,blood routine data,blood biochemical data and clinical data of patients before,during and after hemodialysis during Rosalrestat and ESA were collected for a total of 12 months.The changes of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MBP),mean true variability of systolic blood pressure(SBP-ARV),mean true variability of diastolic blood pressure(DBP-ARV),mean true variability of mean arterial pressure(MAPA)in MHD patients before and after dressing change were compared statistically RV),hemoglobin,and antihypertensive drug dose(DDD).Results: A total of 54 patients with MHD were included in this study,including32 males and 33 females.The primary diseases were chronic nephritis syndrome,hypertensive nephropathy,diabetic nephropathy,obstructive nephropathy,polycystic kidney,nephrotic syndrome,scleroderma kidney injury and unknown etiology.Repeated measures of variance analysis of blood pressure showed that the monthly changes of blood pressure during rosalsitat treatment were smaller than those during ESA treatment.The P values of SBP before dialysis,SBP,DBP during dialysis and MAP during dialysis before and after dressing change were 0.046,< 0.001,0.028,0.014,indicating statistically significant differences.Paired sample T-test results showed that during Rosallistat treatment,BPP-ARV,MAP-ARV before dialysis and MAP-ARV during dialysis were decreased compared with ESA treatment,P =0.0018,0.008,0.006,respectively,and the difference was statistically significant(P<0.05).Erythrocyte,hemoglobin and serum calcium were increased during rosalrestat treatment compared with ESA treatment(P=0.013,P=0.012,0.003),and the difference was statistically significant(P < 0.05).Compared with the high systolic blood pressure variant group,the proportion of males was larger,the number of hospitalizations was higher,the age was relatively older,and the prevalence of diabetes was higher.Conclusions: Maintenance hemodialysis Patients treated with Roxadustat had less fluctuations in blood pressure and less effect on blood pressure than patients treated with r Hu EPO,and Roxadustat increased hemoglobin levels without inferior treatment to ESAs.