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OBJECTIVE To compare the effects of roxadustat and recombination human erythropoietin （rHuEPO） on coronary artery calcification in maintenance hemodialysis （MHD） patients. METHODS In retrospective analysis， MHD patients prescribed roxadustat in the Blood Purification Center of the First Affiliated Hospital of Chongqing Medical University from April 2019 to June 2021 were selected as the ROX group （56 patients）， and MHD patients prescribed rHuEPO during the same period were selected as the EPO group （60 patients）， and follow-up observation was conducted for 12 months. The differences in laboratory index， coronary artery calcification score （CACS）， and cardiac ultrasound parameters before and after treatment as well as the occurrence of cardiac and cerebrovascular adverse events during follow-up period were compared between the two groups. RESULTS There was no statistical difference in CACS between the two groups before and after treatment （P＞0.05）； but the difference of CACS in the ROX group was significantly lower than the EPO group （P＜0.05）. There was no statistically significant difference in cardiac ultrasound parameters and laboratory indexes between the two groups before and after treatment （P＜0.05）. The incidence of apoplexy and myocardial infarction in the ROX group was lower than that in the EPO group （P＜0.05）， and there was no statistically significant difference in the incidence of hospitalization due to heart failure between the two groups （P＞0.05）. CONCLUSIONS Compared with rHuEPO， roxadustat may have a positive effect on delaying coronary artery calcification in MHD patients and may be beneficial in reducing the incidence of myocardial infarction and apoplexy in MHD patients.
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Objective:To observe the efficacy and safety of roxadustat in the treatment of renal anemia in calciphylaxis dialysis patients who had poor response to recombinant human erythropoietin (rHuEPO).Methods:This study was a prospective cohort study. The dialysis patients who were diagnosed with calciphylaxis and had previous regular use of rHuEPO≥3 months with hemoglobin (Hb) levels<110 g/L in the Department of Nephrology of Zhong Da Hospital affiliated to Southeast University from January 1, 2019 to March 28, 2021 were recruited. The effect of oral roxadustat in calciphylaxis dialysis patients with renal anemia was analyzed by self-comparison method.Results:There were totally 18 calciphylaxis dialysis patients with renal anemia enrolled in the study and the age was (49.7±16.2) years old, including 11 males and 7 females, and 14 cases on hemodialysis and 4 cases on peritoneal dialysis. The high-sensitivity C-reactive protein level was 27.3(15.6, 48.5) mg/L(reference value 0-3 mg/L) at baseline. The baseline Hb level was (85.4±11.6) g/L, and after 3 months of oral roxadustat, the Hb level was (105.8±15.2) g/L ( t=-9.282, P<0.001). The Hb compliance rate was 44.4%(8/18). Ferritin decreased significantly at 3 months compared with the baseline level [208.0(59.0, 306.3) μg/L vs 229.0(127.3, 385.2) μg/L, Z=-3.637, P<0.001]. The total iron binding capacity level increased significantly compared with the baseline level [127.0(65.0, 211.5) μmol/L vs 105.5(43.8, 153.7) μmol/L, Z=-2.156, P=0.031]. Transferrin saturation level at 3 months was lower than that at baseline, but there was no significant difference [20.2%(14.2%, 27.7%) vs 20.5%(18.7%, 34.9%), Z=-1.546, P=0.122]. No adverse reactions occurred during the observation period. Conclusion:The application of roxadustat can effectively correct Hb level and improve iron metabolism with high safety in calciphylaxis dialysis patients with renal anemia under inflammatory status.
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OBJECTIVE：To observe the efficacy and safet y of roxadustat in the treatment of chronic kidney disease （CKD） combined with renal anemia. METHODS ：The data of 80 inpatients with CKD combined with renal anemia treated in the nephrology department of the First Affiliated Hospital of Anhui University of Science and Technology during Nov. 2019 to Dec. 2020 were analyzed retrospectively. They were divided into observation group （40 case）and control group （40 case）according to different treatment methods. Control group was given Human erythropoieti n for injection subcutaneously ，100-150 IU/kg every week，3 times a week. Observation group were given Roxadu- stat capsules orally ，100 mg each time for dialysis patients with a bodyweight of 45-＜60 kg，70 mg each time for non- 717060193@qq.com dialysis patients ，3 times a week ；120 mg each time for dialysis patients with bodyweight ≥60 kg and 100 mg each time for non-dialysis patients ，3 times a week. After 4 weeks of treatment ，the dosage of the two groups w as adjusted according to the level of hemoglobin （Hb）. Treatment course of 2 groups were 12 weeks. The levels of anemia indexes （Hb，red blood cell count （RBC），hematocrit（Hct）），iron metabolism indexes （serum iron （Fe），ferritin（Fer），total iron-binding capacity （TIBC），tranfeerrin saturation （TSAT）），lipid metabolism indexes （total cholesterol （TC），triglycerides（TG），high-density lipoprotein （HDL），low-density lipoprotein （LDL））and inflammation index（C-reactive protein （CRP））were detected in 2 groups before treatment and after 12 weeks of treatment. The levels of Hb were observed in high-level CRP subgroup and low-level CRP subgroup ；the occurrence of ADR was recorded in 2 groups during treatment. RESULTS ：Before treatment ，there was no statistical significance in the anemia indexes ，iron metabolism indexes ，lipid metabolism indexes or inflammation index between 2 groups（P＞0.05）. After treatment ，the levels of Hb ，RBC and Hct in 2 groups and the levels of TIBC and HDL in observation group were significantly higher than before treatment. The levels of Fe ，Fer and TSAT in 2 groups and the levels of TC and LDL in observation group were significantly lower than before treatment ；the levels of Hb ，RBC，Hct，TIBC and HDL in observation group were significantly higher than before control group ，while the level of TC was significantly lower than control group （P＜0.05）. The incidence of high reactivity in observation group was significantly higher than control group ，while the incidence of low reactivity was significantly lower than control group （P＜0.05）. There was no statistical significance in the levels of CRP between 2 groups before and after treatment （P＞0.05）. Subgroup comparison results showed that there was no statistical significance in the level of Hb between high-level CRP subgroup and low-level CRP subgroup of 2 groups before treatment （P＞0.05）. After treatment ，the level of Hb in high-level CRP subgroup of observation group was significantly higher than that of high-level CRP subgroup of control group （P＜0.05）. The total incidence of ADR in observation group was significantly lower than control group （P＜0.05），and no severe ADR was observed in 2 groups. CONCLUSIONS ： Roxadustat can effectively improve anemia in CKD patients with renal anemia ，and curative effect is less affected by inflammatory state，and it has good short-term safety.