Abstract: Objective  To observe the efficacy and safety of Roxadustat in the treatment of renal anemia with low erythropoietin (EPO) response in hemodialysis (HD) patients.  Methods   The HD patients treated with Roxadustat for renal anemia and low EPO response were enrolled in this retrospective and self-controlled study. Baseline was defined as the conditions before switching to Roxadustat treatment. Hemoglobin (Hb), iron metabolism indexes, blood lipids, biochemical indexes, blood pressure and hematological indexes were measured at baseline and observation time points after treatment. Adverse drug reactions during the treatment period were collected.   Results   Forty-two HD patients were enrolled in this study. Their average age was 49±13 years old, and dialysis age was 36.88±30.44 months. The leading primary diseases were chronic glomerulonephritis (n=22, 52.38%) and diabetic nephropathy (n=10, 23.81%). The baseline Hb was 85.85±11.14 g/L. The average Hb levels at the 2nd, 4th, 8th, 12th, and 24th weeks of the treatment were significantly higher than the baseline Hb level (F=55.590, P<0.001). After 24 weeks of Roxadustat treatment, the compliance rate of Hb was 83.33% (35 cases), and the response rate to Roxadustat was 92.86% (39 cases). After 12~24 weeks of Roxadustat treatment, serum iron (F=6.706, P=0.003), total iron binding capacity (F=32.368,   P＜0.001), hematocrit (F=22.513, P＜0.001), red blood account (F =26.738, P＜0.001), mean corpuscular volume (F=3.327, P=0.046), and mean corpuscular hemoglobin (F=4.589, P=0.016) increased, and serum ferritin (F=3.584, P=0.037) and low density lipoprotein (F=8.169, P=0.007) declined. No serious adverse events occurred in these patients.  Conclusion  Roxadustat can safely and effectively improve iron metabolism, reduce blood lipids, and increase Hb level in HD patients with renal anemia and low EPO response.

Key words: Hemodialysis, Renal anemia, Roxadustat, Low erythropoietin response