Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysi...Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.展开更多
This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(M...This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.展开更多
Objective: To investigate the effect of high throughput hemodialysis on soluble transferrin receptor in hemodialysis patients and the improvement of renal anemia. Methods: 132 patients receiving maintenance hemodialys...Objective: To investigate the effect of high throughput hemodialysis on soluble transferrin receptor in hemodialysis patients and the improvement of renal anemia. Methods: 132 patients receiving maintenance hemodialysis in our hospital from July 2017 to July 2019 were selected and divided into control group and observation group according to the random number table method, with 66 cases each. The observation group was treated with high-flux hemodialysis, while the control group was treated with low-flux hemodialysis for 6 months. Compare two groups before and after treatment serum beta 2 microglobulin (beta 2 - MG), serum creatinine (Scr), blood urea nitrogen (BUN) level, anemia related index [red blood cells deposited (HCT), hemoglobin (Hb), reticulocyte percentage (Ret%)], iron metabolism index [serum ferritin (SF), transferrin saturation (TSAT)、Hepcidin(Hepc)], soluble transferrin receptor (sTfR) levels and adverse reactions. Results: the levels of 2-MG, Scr and BUN in the two groups before treatment were compared (P>0.05). After treatment, Scr and BUN levels in the two groups were significantly decreased (P<0.05), but were compared between the two groups (P>0.05). The level of 2-MG in the observation group was lower than that in the control group (P<0.05). Before treatment, sTfR, Hb, HCT level and Ret% of the two groups were compared(P>0.05). After treatment, Hb and HCT levels in the observation group were higher than those in the control group, while Ret% were lower than those in the control group, (P<0.05). Before treatment, the levels of ST、TAST、sTfR and Hepc in the two groups were compared (P>0.05). After treatment, the level of ST and TAST in the observation group was higher than that in the control group, The levels of sTfR and Hepc were lower than the control group (P<0.05). The overall incidence of adverse reactions in the observation group (8.93%) was lower than that in the control group (10.14%), with no significant difference (P>0.05). Conclusion: The high-throughput hemodialysis department significantly improved renal anemia in hemodialysis patients, reduced serum sTfR level, and had fewer adverse reactions and higher safety.展开更多
To investigate whether an erythropoietin (EPO) gene-based therapy could serve as an alternative to the repeated injection of rhEPO in treatment to renal anemia, the genetically modified myoblasts of rats, named Myo/ E...To investigate whether an erythropoietin (EPO) gene-based therapy could serve as an alternative to the repeated injection of rhEPO in treatment to renal anemia, the genetically modified myoblasts of rats, named Myo/ EPO, were implanted through intramuscular injection to model rats with renal anemia. The hemoglobin (Hb) and hematocrit (HCT) of the rats increased from (92. 5±3.0) g/L and 0.29 ±0.04 to the peak values of (103.8 ±5.0) g/L and 0. 32 ±0. 04 respectively 14 d after implantation, and sustained the pre-implantation level for 90 d. Otherwise, the control rats implanted with Myo/X, which carried the parent retroviral vector, gradually became severe in anemia. The PCR detection for hEPO cDNA in the rat muscle adjacent to injection sites indicated that the Myo/EPO cells survived for a long period in the muscle of rats. The results primarily demonstrate that myoblast gene transfer of EPO is effective for the treatment of rat renal anemia.展开更多
<strong>Introduction:</strong> Chronic renal failure (CRF) is defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73m<sup>2</sup> for at least three (3) months. Anemia is one of i...<strong>Introduction:</strong> Chronic renal failure (CRF) is defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73m<sup>2</sup> for at least three (3) months. Anemia is one of its most common complications. Anemia increases the risk factor for cardiovascular mortality by 18% per gram of hemoglobin loss. <strong>Objectives:</strong> To determine the prevalence and characteristics of this severe anemia, to determine the indications for transfusion, the complications related to this anemia, the evolution and the prognosis of these patients. <strong>Materials and Methods:</strong> This was a descriptive study with retrospective data collection over 18 months (January 1, 2017 to June 30, 2018) that included hospitalized CRF patients. Were included, non-dialyzed chronic renal failure patients with Hb ≤ 5 g/dl hospitalized during the said period. Not included were chronic renal failure patients with an Hb level ≥ 5 g/dl, those followed up and/or hospitalized outside the study period. <strong>Results:</strong> Among 1176 patients, 26 had severe anemia (Hb level ≤ 5 g/dl) on CRF, a prevalence of 2.21%. The mean age was 40 years ± 32.62 with extremes of 15 and 67 years. Seventeen women and 9 men. The etiology of chronic renal failure (CRF) was hypertensive vascular nephropathy in 50% of cases. CRF was end-stage in 18 patients (69.2%). The mean hemoglobin level was 4.10 g/dl ± 0.64 with extremes of 2 and 5 g/dl. The anemia was microcytic hypochromic in 50% and aregenerative (96.2%). The main symptoms were asthenia in 20 cases (76.9%), dizziness in 20 cases (76.9%), exertional dyspnea in 19 cases (73.1%). Signs of cardiac decompensation (n = 12) were jugular turgor 10 cases (38.5%), hepato-jugular reflux 06 cases (23.1%), mitral insufficiency murmur 06 cases (23.1%). The main complication was left ventricular hypertrophy 17 cases (77.3%). There was no correlation between anemia and sex (p = 0.291), age (p = 0.778), malaria (p = 0.158), etiology of CRF (p = 0.26). The evolution after treatment of anemia was favorable in 19 patients (73.1%), unfavorable in 02 patients (7.7%) and 05 deaths (19.2%). The deaths were of cardiovascular cause: left ventricular insufficiency 04 cases, stroke 01 case. <strong>Conclusion:</strong> Anemia is frequent in patients with chronic renal failure and remains an important risk factor for cardiovascular disease and poor general condition.展开更多
BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney disease.It is associated with increased morbidity and mortality in patients who undergo di...BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney disease.It is associated with increased morbidity and mortality in patients who undergo dialysis.A significant proportion of patients do not respond to iron supplementation and conventional ESAs.We report a case of severe ESA hyporesponsiveness-related anemia that was successfully treated with oral roxadustat.CASE SUMMARY A 59-year-old Chinese woman had high blood glucose for 25 years,maintenance hemodialysis for 7 years,and recurrent dizziness and fatigue for more than 2 years.Laboratory tests showed severe anemia(hemoglobin level of 54 g/L),though bone marrow biopsy,fluorescence in situ hybridization,and hemolysis tests were within normal ranges.We initially administered first-line therapies and other adjuvant treatments,such as blood transfusions,ESAs,and adequate dialysis,but the patient did not respond as anticipated.Her erythropoietinresistant anemia was probably not only due to chronic renal insufficiency.The patient received the hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat(100 mg,three times weekly).After 12 wk of treatment,the patient’s hemoglobin increased significantly,and her symptoms were alleviated.During the follow-up period,adverse drug reactions were controllable and tolerable.CONCLUSION Oral roxadustat is effective and tolerable for the treatment of ESA hyporesponsiveness-related anemia in patients undergoing hemodialysis.展开更多
文摘Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.
文摘This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.
基金Zhongshan Municipal Science and Technology Plan Project(No.2017B1061)
文摘Objective: To investigate the effect of high throughput hemodialysis on soluble transferrin receptor in hemodialysis patients and the improvement of renal anemia. Methods: 132 patients receiving maintenance hemodialysis in our hospital from July 2017 to July 2019 were selected and divided into control group and observation group according to the random number table method, with 66 cases each. The observation group was treated with high-flux hemodialysis, while the control group was treated with low-flux hemodialysis for 6 months. Compare two groups before and after treatment serum beta 2 microglobulin (beta 2 - MG), serum creatinine (Scr), blood urea nitrogen (BUN) level, anemia related index [red blood cells deposited (HCT), hemoglobin (Hb), reticulocyte percentage (Ret%)], iron metabolism index [serum ferritin (SF), transferrin saturation (TSAT)、Hepcidin(Hepc)], soluble transferrin receptor (sTfR) levels and adverse reactions. Results: the levels of 2-MG, Scr and BUN in the two groups before treatment were compared (P>0.05). After treatment, Scr and BUN levels in the two groups were significantly decreased (P<0.05), but were compared between the two groups (P>0.05). The level of 2-MG in the observation group was lower than that in the control group (P<0.05). Before treatment, sTfR, Hb, HCT level and Ret% of the two groups were compared(P>0.05). After treatment, Hb and HCT levels in the observation group were higher than those in the control group, while Ret% were lower than those in the control group, (P<0.05). Before treatment, the levels of ST、TAST、sTfR and Hepc in the two groups were compared (P>0.05). After treatment, the level of ST and TAST in the observation group was higher than that in the control group, The levels of sTfR and Hepc were lower than the control group (P<0.05). The overall incidence of adverse reactions in the observation group (8.93%) was lower than that in the control group (10.14%), with no significant difference (P>0.05). Conclusion: The high-throughput hemodialysis department significantly improved renal anemia in hemodialysis patients, reduced serum sTfR level, and had fewer adverse reactions and higher safety.
基金Project supported by the National Natural Science Foundation of China (Grant No. 39470321).
文摘To investigate whether an erythropoietin (EPO) gene-based therapy could serve as an alternative to the repeated injection of rhEPO in treatment to renal anemia, the genetically modified myoblasts of rats, named Myo/ EPO, were implanted through intramuscular injection to model rats with renal anemia. The hemoglobin (Hb) and hematocrit (HCT) of the rats increased from (92. 5±3.0) g/L and 0.29 ±0.04 to the peak values of (103.8 ±5.0) g/L and 0. 32 ±0. 04 respectively 14 d after implantation, and sustained the pre-implantation level for 90 d. Otherwise, the control rats implanted with Myo/X, which carried the parent retroviral vector, gradually became severe in anemia. The PCR detection for hEPO cDNA in the rat muscle adjacent to injection sites indicated that the Myo/EPO cells survived for a long period in the muscle of rats. The results primarily demonstrate that myoblast gene transfer of EPO is effective for the treatment of rat renal anemia.
文摘<strong>Introduction:</strong> Chronic renal failure (CRF) is defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73m<sup>2</sup> for at least three (3) months. Anemia is one of its most common complications. Anemia increases the risk factor for cardiovascular mortality by 18% per gram of hemoglobin loss. <strong>Objectives:</strong> To determine the prevalence and characteristics of this severe anemia, to determine the indications for transfusion, the complications related to this anemia, the evolution and the prognosis of these patients. <strong>Materials and Methods:</strong> This was a descriptive study with retrospective data collection over 18 months (January 1, 2017 to June 30, 2018) that included hospitalized CRF patients. Were included, non-dialyzed chronic renal failure patients with Hb ≤ 5 g/dl hospitalized during the said period. Not included were chronic renal failure patients with an Hb level ≥ 5 g/dl, those followed up and/or hospitalized outside the study period. <strong>Results:</strong> Among 1176 patients, 26 had severe anemia (Hb level ≤ 5 g/dl) on CRF, a prevalence of 2.21%. The mean age was 40 years ± 32.62 with extremes of 15 and 67 years. Seventeen women and 9 men. The etiology of chronic renal failure (CRF) was hypertensive vascular nephropathy in 50% of cases. CRF was end-stage in 18 patients (69.2%). The mean hemoglobin level was 4.10 g/dl ± 0.64 with extremes of 2 and 5 g/dl. The anemia was microcytic hypochromic in 50% and aregenerative (96.2%). The main symptoms were asthenia in 20 cases (76.9%), dizziness in 20 cases (76.9%), exertional dyspnea in 19 cases (73.1%). Signs of cardiac decompensation (n = 12) were jugular turgor 10 cases (38.5%), hepato-jugular reflux 06 cases (23.1%), mitral insufficiency murmur 06 cases (23.1%). The main complication was left ventricular hypertrophy 17 cases (77.3%). There was no correlation between anemia and sex (p = 0.291), age (p = 0.778), malaria (p = 0.158), etiology of CRF (p = 0.26). The evolution after treatment of anemia was favorable in 19 patients (73.1%), unfavorable in 02 patients (7.7%) and 05 deaths (19.2%). The deaths were of cardiovascular cause: left ventricular insufficiency 04 cases, stroke 01 case. <strong>Conclusion:</strong> Anemia is frequent in patients with chronic renal failure and remains an important risk factor for cardiovascular disease and poor general condition.
基金Supported by the National Natural Science Foundation of China,No.81770730and the Hunan Provincial Natural Science Fund,No.2017JJ2352.
文摘BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney disease.It is associated with increased morbidity and mortality in patients who undergo dialysis.A significant proportion of patients do not respond to iron supplementation and conventional ESAs.We report a case of severe ESA hyporesponsiveness-related anemia that was successfully treated with oral roxadustat.CASE SUMMARY A 59-year-old Chinese woman had high blood glucose for 25 years,maintenance hemodialysis for 7 years,and recurrent dizziness and fatigue for more than 2 years.Laboratory tests showed severe anemia(hemoglobin level of 54 g/L),though bone marrow biopsy,fluorescence in situ hybridization,and hemolysis tests were within normal ranges.We initially administered first-line therapies and other adjuvant treatments,such as blood transfusions,ESAs,and adequate dialysis,but the patient did not respond as anticipated.Her erythropoietinresistant anemia was probably not only due to chronic renal insufficiency.The patient received the hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat(100 mg,three times weekly).After 12 wk of treatment,the patient’s hemoglobin increased significantly,and her symptoms were alleviated.During the follow-up period,adverse drug reactions were controllable and tolerable.CONCLUSION Oral roxadustat is effective and tolerable for the treatment of ESA hyporesponsiveness-related anemia in patients undergoing hemodialysis.
