Clinical trial of roxadustat in the treatment of maintenance hemodialysis patients with renal anemia
Objective To investigate the clinical efficacy and microinflammatory response of roxadustat and recombinant human erythropoietin(rHuEPO)in the treatment of renal anemia(RA)in maintenance hemodialysis(MHD).Methods MHD RA patients with uremia were analyzed retrospectively.The control group was given subcutaneous injection of 120 U·kg-1 rHuEPO and iron sucrose injection 100 mg.After 2 h of hemodialysis,rHuEPO was slowly dropped into the intravenous end of the dialyser for more than 30 min,once a week.The treatment group was additionally treated with roxadustat capsule,starting at 100 mg,3 times a week for 3 months.The clinical efficacy and serum creatinine(Scr),hemoglobin(Hb),hematocrit(Hct),urea nitrogen(BUN),serum creatinine(SCR),ferritin(SF),transferrin saturation(TSAT),transferrin(TRF),centriocyte absolute value/lymphocyte absolute value(NLR)and absolute value of neutrophils/absolute value of lymphocytes(NLR),absolute value of platelets/absolute value of lymphocytes(PLR),and high-sensitivity C-reactive protein(hs-CRP)levels,as well as the occurrence of adverse drug reactions were compared.Results Thirty-two cases were included in the treatment group and twenty-eight cases in the control group.After treatment,the total effective rate of the treatment group and the control group were 93.75%(30 cases/32 cases)and 75.00%(21 cases/28 cases),respectively,and the difference was statistically significant(P<0.05).Hb in treatment group and control group were(113.64±12.58)and(104.39±11.67)g·L-1;Hct were(31.51±4.33)%and(28.72±5.47)%;TSAT were(21.11±1.26)%and(19.57±1.29)%,respectively;SF were(161.25±7.91)and(210.68±9.02)ng·mL-1;TRF were(13.06±1.29)and(16.57±1.45)g·L-1,respectively;BUN were(21.90±4.41)and(24.37±3.51)mmol·L-1;Scr were(862.56±97.81)and(980.30±99.67)μmnol·L-1;NLR were(1.30±0.29)%and(2.01±0.41)%,respectively;PLR levels were(86.57±16.55)%and(104.82±26.31)%,and hs-CRP levels were(4.82±0.36)and(6.57±0.55)mg·L-1,respectively.Compared with control group,the above indexes except BUN and Scr in treatment group were statistically significant(all P<0.05).The adverse drug reactions of the treatment group were mainly digestive tract reaction and liver function injury,while the adverse drug reactions of the control group were mainly elevated blood potassium,digestive tract reaction and liver function injury.The incidence of total adverse drug reactions in treatment group and control group were 12.50%and 21.43%,respectively,with no statistical significance(P>0.05).Conclusion roxadustat can effectively improve the efficacy of MHD RA patients with uremia,relieve anemia and reduce microinflammatory response.
roxadustatrecombinant human erythropoietinuremiamaintenance hemodialysisrenal anemiamicroinflammatory response