A Retrospective Real-World Multicenter Study of the Efficacy and Safety of Desidustat in Chronic Kidney Disease-Related Anemia

Background: Chronic kidney disease (CKD) often leads to a relative deficiency of erythropoietin (EPO), resulting in anemia. Exogenous erythropoietin analogs are commonly used to address this deficiency. Desidustat, a recently approved hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), enhances endogenous EPO production. This study evaluates the multicenter outcomes of desidustat in treating CKD-induced anemia. Methodology: This retrospective analysis included patients with CKD-induced anemia who received desidustat. Patients were followed up at one month, two months, and six months post-treatment initiation. Oral or intravenous (IV) iron was administered based on iron depletion status. Dosage adjustments, therapy compliance, hemoglobin (Hb) levels, and safety parameters were assessed at each follow-up. Results: The study included 517 patients with CKD-induced anemia, comprising 39.38% (204) male patients and 60.61% (313) female patients, with a mean age of 57.86 ± 14.24 years. Comorbid conditions included diabetes mellitus (44.29%, 229 patients) and hypertension (61.31%, 317 patients). The majority of patients (88.18%, 456 patients) received desidustat 100 mg thrice weekly. Hemoglobin levels increased from a baseline mean of 9.11 ± 1.38 g/dL to 9.83 ± 1.52 g/dL at follow-up 1, 10.10 ± 1.59 g/dL at follow-up 2, and 10.13 ± 1.74 g/dL at follow-up 3 (p < 0.005), reflecting sustained improvements of 9.13% (0.72 g/dL), 12.05% (0.99 g/dL), and 12.39% (1.02 g/dL) from baseline, respectively. Both dialysis-dependent and pre-dialysis patients showed a consistent rise in Hb levels from baseline, with a numerically greater increase observed in the pre-dialysis group, likely due to better residual kidney function. The treatment was generally well-tolerated, with mild adverse events (AEs) such as constipation and throat pain, which did not require discontinuation of therapy. Conclusion: Desidustat is a safe and effective oral therapy for CKD-induced anemia, demonstrating consistent Hb increases in both dialysis and pre-dialysis patients. Its oral administration route enhances usability, particularly in tropical conditions.