Abstract: 【Abstract】Objective To investigate the effects of Roxadustat on iron metabolism in maintenance hemodialysis (MHD) patients with microinflammation state and renal anemia, in order to provide theoretic bases for the diagnosis and treatment of these patients. Methods A total of 68 MHD patients with microinflammation state and renal anemia admitted to Linyi Central Hospital from May to October, 2020 were enrolled in this study. They were equally divided into control group and study group by random number table method. The control group was treated with recombinant human erythropoietin (rhEPO) after hemodialysis, while the study group was treated with Roxadustat. They were treated for 3 months. Hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TSAT), transferrin, serum ferritin (SF) and hepcidin were compared before and after 3 months of treatment between the two groups. Results There were no significant differences in age, gender, dialysis age, and the levels of Hb, SI, TIBC, TSAT, transferrin, SF, hepcidin, CRP and PTH between the two groups before treatment (P＞0.05). In the study group after the treatment, Hb, SI, transferrin, and TIBC increased significantly (for Hb, t=4.245, P<0.001 after 2 months, and t=6.433, P<0.001 after 3 months; for SI, t=2.984, P<0.001 after 2 months, and t=5.433, P<0.001 after 3 months;
for transferrin, t=3.254, P<0.001 after 2 months, and t=4.329, P<0.001 after 3 months; for TIBC, t=3.854, P< 0.001 after 2 months, and t=5.322, P<0.001 after 3 months), while SF, TSAT and hepcidin decreased significantly (for SF, t=2.245, P<0.030 after one month, t=3.851, P<0.001 after 2 months, and t=6.433, P<0.001 after 3 months; for TSAT, t=2.268, P<0.032 after one month, t=3.567, P<0.001 after 2 months, and t=4.852, P<0.001 after 3 months; for hepcidin, t=3.445, P<0.001 after 2 months, and t=7.343, P<0.001 after 3 months), as compared with those in the control group. Conclusion Compared with rhEPO, Roxadustat treatment can significantly correct abnormal iron metabolism, increase iron utilization, and improve renal anemia in MHD patients with microinflammation state and renal anemia. This study also provides theoretic bases for the diagnosis and treatment of these patients.

Key words: Renal anemia, Roxadustat, Iron metabolism, Hepcidin