Abstract: Objective  To observe the use of Roxadustat to replace recombinant human erythropoietin (rhEPO) in the treatment of renal anemia in maintenance dialysis (MHD) patients.  Methods  Twenty-one MHD patients complicated with renal anemia and treated in The Affiliated Hospital of Xuzhou Medical University during August 2020 to October 2021 were enrolled in this study. They were treated with rhEPO using the dose based on body mass and anemia degree for at least 3 months, but their hemoglobin continued to be <100g/L. Roxadustat was then used to replace rhEPO therapy. They were followed up for an average period of 24 weeks. Their clinical indicators were compared before and after Roxadustat therapy.  Results  After 4, 8, 12, 16, 20 and 24 weeks of Roxadustat therapy, RBC count, hemoglobin and RBC specific volume became higher(F=10.290, 9.053 and 9.858 respectively;P＜0.001); reticulocyte count increased beginning from the 4th week, and the differences were statistically significant at the 8th, 12th and 24th weeks (F=6.031, P＜0.001) as compared with that before the Roxadustat therapy; total iron binding capacity increased after 12 and 24 weeks of Roxadustat therapy (F=9.336, P=0.002); total cholesterol and low density lipoprotein decreased (F=14.200 and 12.090; P＜0.001). After Roxadustat therapy, reticulocyte percentage, hemoglobin content in reticulocytes, immature reticulocyte ratio, serum iron, ferritin, transferrin saturation and erythropoietin (EPO) level remained unchanged as compared with those before Roxadustat therapy (F=0.881, 3.067, 0.476, 3.629, 2.783 and 1.910, and t=-1.020 respectively; P=0.421, 0.057, 0.679, 0.067, 0.093, 0.158 and 0.315 respectively).  Conclusions In MHD patients complicated with renal anemia and poor responses to rhEPO treatment, Roxadustat can effectively improve anemia and lipid metabolism, with less adverse reactions.

Key words: Roxadustat, Maintenance dialysis, Renal anemia, Chronic kidney disease