Objective  To analyze the effect of roxadustat and human erythropoietin injection on hemodialysis patients.

Methods  Data of the patients who received hemodialysis treatment in Emergency General Hospital from December 2021 to December 2023 were selected and the patients were divided into the test group (treated with oral roxadustat) and the control group (treated with human erythropoietin subcutaneous injection) according to the treatment schemes. The levels of hemoglobin (HB), hematocrit (HCT), erythropoietin (EPO), transferrin saturation (TSAT), unsaturated iron binding capacity (UIBC), ferritin (SF), fibroblast growth factor-23 (FGF-23), NADPH oxidase 2 (NOX2), advanced protein oxidation product (AOPP), P-selectin (CD62P), C-reactive protein (CRP), interleukin-1β (IL^-1β), interleukin-6 (IL-6), claudin-1 (CLDN-1) and the incidence of adverse reactions were compared between the two groups.

Results  A total of 80 patients were included, with 40 patients in each group. After treatment, the levels of Hb, HCT, SF, TSAT and CLDN-1 in the test group were higher than those in the control group, while the levels of EPO, UIBC, FGF-23, AOPP, NOX2, CD62P, CRP, IL^-1β and IL-6 in the test group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the test group was lower than that in the control group (P<0.05).

Conclusion   Compared with human erythropoietin injection, roxadustat can significantly correct the anemia state of hemodialysis patients, regulate the iron metabolism, improve the inflammation and the oxidative stress response, and has high effectiveness and safety.

1.中国医师协会肾脏内科医师分会肾性贫血指南工作组. 中国肾性贫血诊治临床实践指南[J]. 中华医学杂志, 2021, 101(20): 1463-1502. DOI: 10.3760/cma.j.cn112137-20210201-00309.

2.郭永杰. 重组人促红素(EPO)联合复方α-酮酸纠正维持性血透患者低白蛋白血症临床疗效分析[J]. 数理医药学杂志, 2021, 34(11): 1637-1639. [Guo YJ. Clinical efficacy analysis of recombinant human erythropoietin (EPO) combined with compound alpha ketoacid in correcting hypoalbuminemia in maintenance hemodialysis patients[J]. Journal of Mathematical Medicine, 2021, 34(11): 1637-1639.] DOI: 10.3969/j.issn.1004-4337. 2021.11.021.

3.陈瑞丰, 于沛, 王志婷, 等. 罗沙司他联合多糖铁复合物、生血宁治疗重组人促红素效果不佳的维持性血液透析肾性贫血患者的临床研究[J]. 中国临床药理学杂志, 2024, 40(12): 1704-1708. [Chen RF, Yu P, Wang ZT, et al. Clinical study on the combination of rosuvastatin, polysaccharide iron complex, and Shengxuening in the treatment of maintenance hemodialysis renal anemia patients with poor efficacy of recombinant human erythropoietin[J]. Chinese Journal of Clinical Pharmacology, 2024, 40(12): 1704-1708.] DOI: 10.13699/j.cnki.1001-6821.2024.12.002.

4.Tian L, Wang M, Liu M, et al. Cardiovascular and renal safety outcomes of hypoxia-inducible factor prolyl-hydroxylase inhibitor roxadustat for anemia patients with chronic kidney disease: a systematic review and Meta-analysis[J]. Ren Fail, 2024, 46(1): 2313864. DOI: 10.1080/0886022X.2024.2313864.

5.中华医学会肾脏病学分会肾性贫血诊断和治疗共识专家组. 肾性贫血诊断与治疗中国专家共识(2018修订版)[J]. 中华肾脏病杂志, 2018, 34(11): 860-866. DOI: 10.3760/cma.j.issn.1001?7097.2018.11.012.

6.Bruce G, Schulga P, Reynolds BC. Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review[J]. Clin Kidney J, 2022, 15(8): 1483-1505. DOI: 10.1093/ckj/sfac058.

7.Mazahir R, Anand K, Pruthi PK. Comparison of darbepoetin alpha and recombinant human erythropoietin for treatment of anemia in pediatric chronic kidney disease: a non-inferiority trial from India[J]. Eur J Pediatr, 2023, 182(1): 101-109. DOI: 10.1007/s00431-022-04650-1.

8.Provenzano R, Shutov E, Eremeeva L, et al. Roxadustat for anemia in patients with end-stage renal disease incident to dialysis[J]. Nephrol Dial Transplant, 2021, 36(9): 1717-1730. DOI: 10.1093/ndt/gfab051.

9.刘紫秋, 杨婷, 王路路, 等. 口服铁剂联合重组人促红素注射液与口服铁剂联合罗沙司他对血液透析患者血红蛋白和铁蛋白影响的对比观察[J]. 临床和实验医学杂志, 2023, 22(2): 153-157. [Liu ZQ, Yang T, Wang  LL, et al. Comparative observation of the effects of oral iron combined with recombinant human erythropoietin injection and oral iron combined with rosuvastatin on hemoglobin and ferritin in hemodialysis patients[J]. Journal of Clinical and Experimental Medicine, 2023, 22 (2): 153-157.] DOI: 10.3969/j.issn.1671-4695.2023.02.013.

10.赵雯雯, 王妍菲, 王梦慈, 等. 罗沙司他对维持性血液透析患者贫血及FGF-23的影响[J]. 实用药物与临床, 2023, 26(11): 1022-1026. [Zhao WW, Wang YF, Wang MC, et al. The effect of rosuvastatin on anemia and FGF-23 in maintenance hemodialysis patients[J]. Practical Medicine and Clinical Practice, 2023, 26 (11): 1022-1026.] DOI: 10.14053/j.cnki.ppcr.202311013.

11.Daryadel A, Bettoni C, Haider T, et al. Erythropoietin stimu-lates fibroblast growth factor 23 (FGF23) in mice and men[J]. Pflugers Arch, 2018, 470(10): 1569-1582. DOI: 10.1007/s00424-018-2171-7.

12.Noonan ML, Clinkenbeard EL, Ni P, et al. Erythropoietin and a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHDi) lowers FGF23 in a model of chronic kidney disease (CKD)[J]. Physiol Rep, 2020, 8(11): e14434. DOI: 10.14814/phy2.14434.

13.Caliskan Y, Demir E, Karatay E, et al. Oxidative stress and macrophage infiltration in IgA nephropathy[J]. J Nephrol, 2022, 35(4): 1101-1111. DOI: 10.1007/s40620-021-01196-7.

14.Hofni A, Ali FEM, Ibrahim ARN, et al. Renoprotective effect of thymoquinone against streptozotocin-induced diabetic nephropathy: role of nox2 and nrf2 signals[J]. Curr Mol Pharmacol, 2023, 16(8): 905-914. DOI: 10.2174/1874467216666230125150112.

15.刘静, 平立英. MMP-9、 MCP-1、CD62P在慢性肾脏病患者血清中的表达[J]. 中国临床研究, 2020, 33(9): 1217-1220. [Liu J, Ping LY. The expression of MMP-9, MCP-1, and CD62P in the serum of patients with chronic kidney disease[J]. Chinese Journal of Clinical Research, 2020, 33(9): 1217-1220.] DOI: 10.13429/j.cnki.cjcr.2020.09.017.

16.Hu D, Liu W, Yu W, et al. Psyllium seed husk regulates the gut microbiota and improves mucosal barrier injury in the colon to attenuate renal injury in 5/6 nephrectomy rats[J]. Ren Fail, 2023, 45(1): 2197076. DOI: 10.1080/0886022X.

17.徐亚光, 张静静, 王天舒. 罗沙司他联合血液透析对尿毒症患者的疗效及对claudin-1、β2-MG水平的影响 [J]. 国际泌尿系统杂志, 2024, 44(2): 323-328. [Xu YG, Zhang JJ, Wang TS. The therapeutic effect of rosuvastatin combined with hemodialysis on patients with uremia and its impact on claudin-1 and β2-MG levels[J]. International Journal of Urology, 2024, 44(2): 323-328.] DOI: 10.3760/cma.j.cn431460-20220718-00077.

18.何荃, 渠宁, 雷子彤, 等. 罗沙司他对CKD大鼠肠生物屏障功能的影响[J]. 西部医学, 2024, 36(2): 166-174. [He Q, Qu N, Lei ZT, et al. The effect of rosuvastatin on intestinal biological barrier function in CKD rats[J]. Western Medicine, 2024, 36 (2): 166-174.] DOI: 10.3969/j.issn.1672-3511.2024.02.003.

19.Provenzano R, Szczech L, Leong R, et al. Efficacy and cardiovascular safety of roxadustat for treatment of anemia in patients with non-dialysis-dependent CKD: pooled results of three randomized clinical trials[J]. Clin J Am Soc Nephrol, 2021, 16(8): 1190-1200. DOI: 10.2215/CJN.16191020.

20.张蓬杰, 荀利如, 丁通, 等. 应用罗沙司他与重组人促红素治疗的初始血液透析肾性贫血患者的临床疗效及安全性分析[J]. 临床肾脏病杂志, 2022, 22(11): 917-923. [Zhang PJ, Xun LR, Ding T, et al. Clinical efficacy and safety analysis of initial hemodialysis renal anemia patients treated with rosuvastatin and recombinant human erythropoietin[J]. Journal of Clinical Nephrology, 2022, 22(11): 917-923.] DOI: 10.3969/j.issn.1671-2390.2022.11.006.