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. 2023 Apr 10;16(9):1500-1507.
doi: 10.1093/ckj/sfad080. eCollection 2023 Sep.

Effect of roxadustat on red blood cell lifespan in patients with long-term haemodialysis: a single-centre, prospective, single-arm study

Bing Zhao  1 , Xiaowei Yang  1 , Weidan Li  2 , Huizi Zhu  3 , Qian Meng  1 , Yongjian Ma  4 , Yun Liu  5 , Yan Zhou  1 , Jiangong Lin  1 , Chunjuan Zhai  6 , Lian Zhao  2 , Jing Sun  1   3 , Rong Wang  1   3
Affiliations

Effect of roxadustat on red blood cell lifespan in patients with long-term haemodialysis: a single-centre, prospective, single-arm study

Bing Zhao et al. Clin Kidney J. .

Abstract

Background: Reduced survival of red blood cells (RBCs) in patients with chronic kidney disease (CKD) is thought to contribute to renal anaemia. Although renal anaemia improved greatly because of the wide use of erythropoiesis-stimulating agents (ESAs) and the advancement of dialysis techniques, RBC longevity seems not to be obviously ameliorated.

Methods: In this single-centre, single-arm trial, patients who had been undergoing haemodialysis and ESA therapy with epoetin alfa for at least 12 weeks changed their anti-anaemia drugs from epoetin alfa to oral roxadustat three times per week for 24 weeks. The primary endpoint was the change in RBC lifespan from baseline at week 24. The change in the circulating percentage of eryptotic RBCs, RBC deformability and RBC oxygen transport ability were also assessed.

Results: A total of 27 patients were enrolled, with 26 completing the full course of intervention. At baseline, the average RBC lifespan was 60.1 days [standard deviation (SD) 14.4; n = 27]. At the end of the study period, 26 patients had an RBC lifespan measurement (83.9 days on average; SD 21.9). The RBC lifespan increased by 22.8 days on average [95% confidence interval (CI) 15.5-30.0, P < .001]. This equated to an average RBC lifespan increase of 39.2% (95% CI 27.8-50.6). The percentage of circulating eryptotic RBCs, erythrocyte filtration index and the pressure at which haemoglobin is 50% saturated decreased significantly from baseline to week 24 (1.39 ± 0.44% versus 0.89 ± 0.25%, P < .0001; 0.29 ± 0.12 versus 0.16 ± 0.08, P < .0001 and 32.54 ± 4.83 versus 28.40 ± 2.29, P < .001, respectively).

Conclusion: Roxadustat prolonged RBC lifespan in patients with long-term haemodialysis.

Keywords: RBC deformability; RBC lifespan; haemodialysis; renal anaemia; roxadustat.

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Conflict of interest statement

None declared.

Figures

Figure 1:
Figure 1:
Mean levels and percentage change from baseline in RBC lifespan over time (ITT population). The ITT population (full analysis set) included all the patients who enrolled in the study and had baseline and post-baseline RBC lifespan values assessed during treatment. (A) T bars indicate SD and (B) I bars indicate 95% CI. ***P < .001 and ****P < .0001.
Figure 2:
Figure 2:
Mean change in RBC lifespan from baseline at week 24, according to Hb subgroup. Group 1: Hb change from baseline at week 24 ≤10 g/L (n = 12); group 2, Hb change from baseline at week 24 >10 g/L (n = 14). T bars indicate 95% CI.
Figure 3:
Figure 3:
Mean levels in RBC lifespan from baseline at week 24 in eryptosis, RBC deformability and P50. I bars indicate SD.
See this image and copyright information in PMC

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