Cihan UYSAL
Comprehensive Medicine - 2026;18(1):25-33
Objective: A reduced treatment response to epoetin (EPO) therapy is a clinical challenge among hemodialysis (HD) patients. Outcomes of roxadustat in HD patients who had hyporesponse to EPO therapy were investigated. Materials and Methods: This retrospective study analyzed adult patients undergoing long-term HD. Hyporesponsiveness to EPO was defined as a hemoglobin (Hb) level consistently below 10 g/dL despite receiving maximum EPO and having adequate iron stores for at least three months. The target Hb threshold for following roxadustat was defined as >=11 g/dL. Results: A total of 227 HD patients were screened, and 25 patients were enrolled. The mean age was 55.1+/-17.5 years. Median HD duration was 47 (19-118) months. Average Hb during the EPO treatment was 8.7+/-0.7 g/dL, compared to 9.8+/-1.3 g/dL during the roxadustat treatment. Increased Hb following roxadustat was observed in 17 patients (68.0%). Target Hb was achieved in 14 (56%) patients following roxadustat. Erythropoietin resistance index was 17.6+/-1.4 IU/kg/gHb in patients who responded to roxadustat, whereas it was 19.4+/-3.3 IU/kg/gHb in non-responders (p=0.087). The average Hb level was significantly increased during the roxadustat period (p=0.011). Lower uric acid (p=0.003) and higher Kt/V (p=0.044) were observed in patients who achieved target Hb. Pre-treatment transferrin saturation was correlated with the amount of Hb change following roxadustat (p=0.034). Conclusion: The current study should be considered a pioneering effort, and findings support significant treatment success with roxadustat.
