Study on the Clinical Efficacy of Relationship between Serum 25(OH)D,NGAL,Hepcidin and Roxadustat Capsules in the Treatment of Renal Anemia in Maintenance Hemodialysis Patients
Objective:To investigate the clinical efficacy of relationship between serum 25-hydroxyvitamin D[25(OH)D],neutrophil gelatinase-associated lipocalin(NGAL),Hepcidin(Hepcidin)and roxadustat capsules in the treatment of renal anemia in maintenance hemodialysis(MHD)patients.Methods:137 MHD patients with renal anemia who were treated with roxadustat capsules in the Affiliated Hospital of Xuzhou Medical University from October 2020 to October 2022 were selected,and patients were divided into effective group(86 cases)and ineffective group(51 cases)according to the effect of 12 weeks of treatment.The serum levels of 25(OH)D,NGAL and Hepcidin were detected before treatment,the factors affecting the efficacy of roxadustat capsules were analyzed by multivariate Logistic regression model,the value of 25(OH)D,NGAL and Hepcidin in predicting the efficacy of roxadustat capsules were analyzed by receiver operating characteristic(ROC)curve.Results:The level of serum 25(OH)D in ineffective group before treatment was lower than that in effective group(P＜0.05),and the levels of NGAL and Hepcidin were higher than those in effective group(P＜0.05).High level of NGAL and high level of Hepcidin were risk factors for ineffective treatment of renal anemia in MHD patients with roxadustat capsules(P＜0.05),high level of 25(OH)D,combined with hemofiltration or hemoperfusion,and urea clearance index(Kt/v)＞1.2 were protective factors(P＜0.05).The area under the curve(AUC)of 25(OH)D,NGAL,and Hepcidin combined to predict the efficacy of rosastat capsules was 0.853,which was higher than the prediction of individual indicators.Conclusion:The serum 25(OH)D level decreased and NGAL and Hepcidin level increased in patients with MHD renal anemia before treatment with roxadustat capsules,the above level changes were related to the treatment effect of roxadustat capsules,the combination of 25(OH)D,NGAL and Hepcidin could improve the predictive value of the therapeutic effect of roxadustat capsules.
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