The Effect of Roxadustat on Renal Anemia Patients with Overt Infection Undergoing Long-term Dialysis: A Single-center Retrospective Cohort Study

Abstract The effect of oral roxadustat in dialysis patients with renal anemia and overt infections remains elusive. A retrospective cohort analysis of the effect of roxadustat and recombinant human EPO injection (rHuEPO) on anemia-related parameters, infection indicators and biochemical parameters in patients with overt infection before and after treatment was performed by screening 2816 dialysis patients with renal anemia and overt infection and dividing them into two groups. A total of 167 patients were enrolled (88 in the roxadustat group and 79 in the rHuEPO group) and the mean baseline hemoglobin levels of each group were 90.3 ± 15.2 g/L and 91.9 ± 17.8 g/L respectively. A total of 167 patients completed an average of 10.6 ± 3.3 days of infection treatment. The types of overt infections in patients included pulmonary infections, peritoneal dialysis-associated peritonitis, catheter-related infections, urinary tract infections, and other types of infection. Compared with rHuEPO, roxadustat significantly increased hemoglobin levels and △Hb values in dialysis patients after infection. Moreover, significant differences in △Hb changes were observed between the roxadustat group and the rHuEPO group. △Hb was clearly greater in the roxadustat group than in the rHuEPO group among PD patients. The △Hb value for peritoneal dialysis-associated peritonitis significantly differed from that for pulmonary infections, and the △Hb value for other infections tended to be greater than the △Hb value for pulmonary infection. The relationship between the severity of infection and the △Hb value based on the PCT level showed that the more severe the degree of overt infection was, the lower the △Hb value. Thus, compared with rHuEPO, roxadustat alleviated renal anemia in dialysis patients with overt infection.