Effect of roxadustat on renal anemia of uremic patients with hemodialysis and peritoneal dialysis
AIM To observe the difference of clinical efficacy and safety between regular hemodialysis(HD)and peritoneal dialysis(PD)uremic patients treated with roxadustat for renal anemia.METHODS From December 2019 to March 2023,102 renal anemia patients treated with roxadustat for uremic dialysis were selected.The initial dose of roxadustat was chosen based on weight,with 100 mg orally for patients weighing 45 to 60 kg and 120 mg for those weighing≥60 kg.The medication was administered three times a week for 12 consecutive weeks,with dosage adjustments according to hemoglobin(Hb)levels.According to the dialysis method,there were 50 cases in the PD group and 52 cases in the HD group.Within the groups,those with high sensitive C-reactive protein(hs-CRP)≥ 6 mg·L-1 were classified as high hs-CRP subgroup,while those with<6 mg·L-1 were considered the normal hs-CRP subgroup.Changes in anemia-related indicators,iron metabolism,lipid metabolism,and adverse reactions before and after roxadustat treatment were observed in both groups.RESULTS After 12 weeks of treatment with roxadustat,the levels of Hb,red blood cell count(RBC),hematocrit(HCT),and serum iron(SI)in the both groups all increased compared with before the treatment(P<0.05),while the levels of serum ferritin(SF),total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)all decreased(P<0.05).After treatment,the levels of Hb,RBC,HCT,SI,TC,and LDL-C in the PD group were significantly higher than those in the HD group(P<0.05).There were no significant differences in transferrin saturation(TSAT),total iron-binding capacity(TIBC),and high-density lipoprotein cholesterol(HDL-C)levels within and between the groups before and after the treatment(P>0.05).There were no significant differences in TG and SF levels and the occurrence of adverse reactions between the two groups(P>0.05).After 12 weeks of treatment,the average Hb level of the high hs-CRP subgroup and normal hs-CRP subgroup of the two groups significantly increased compared with before treatment(P<0.05),and there was no significant difference between the two subgroups(P>0.05).CONCLUSION Roxadustat is effective in improving renal anemia in uremia patients with HD or PD,and the short-term safety is good.Compared with HD patients,anemia is more significantly improved in PD patients.