Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 8701128 Publication Model: Print Cited Medium: Internet ISSN: 1525-6049 (Electronic) Linking ISSN: 0886022X NLM ISO Abbreviation: Ren Fail Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: New York, N.Y. : M. Dekker, c1987-
    • Subject Terms:
      Erythrocyte Aging* ; Renal Dialysis*; Anemia/*drug therapy ; Epoetin Alfa/*therapeutic use ; Glycine/*analogs & derivatives ; Isoquinolines/*therapeutic use ; Renal Insufficiency, Chronic/*complications; Adult ; Case-Control Studies ; Cross-Sectional Studies ; Glycine/therapeutic use ; Hemoglobins/analysis ; Humans ; Linear Models ; Male ; Middle Aged ; Renal Insufficiency, Chronic/therapy ; Treatment Outcome
    • Abstract:
      Introduction: A significant decrease in red blood cell (RBC) survival has been observed in patients with renal failure, which is supposed to contribute to renal anemia. The aim of this observational study was to determine RBC survival in hemodialysis (HD) patients treated with roxadustat or recombinant human erythropoietin (rhuEPO) compared with healthy persons.
      Methods: RBC lifespan was measured by Levitt's CO breath test with newly developed automatic instrument ELS Tester.
      Results: A total of 102 patients receiving long-term HD from two independent dialysis centers enrolled in the study, of whom 62 were treated with rhuEPO and 40 were on roxadustat therapy. A total of 25 healthy participants were recruited to match HD participants according to age and sex. Median RBC survival times in rhuEPO, roxadustat, and control groups were 65.0 (25th-75th percentile, 49.5-77.3), 75.5 (25th-75th percentile, 57.3-99.3), and 108.0 (25th-75th percentile, 89.0-141.5) d, respectively. Patients treated with roxadustat had significantly longer RBC survival time than patients treated with rhuEPO ( p  < .05). In multivariate analysis of factors affecting RBC lifespan in the whole HD patients, anemia treatment drugs (rhuEPO/roxadustat) and levels of hemoglobin were the significantly independent factors. RBC survival was not found to correlate with either weekly rhuEPO dosage ( r = -0.087, p  = .500) or weekly roxadustat dosage ( r = -0.267, p  = .110) in our cohort.
      Conclusions: HD patients treated with roxadustat had significantly longer RBC survival time than patients treated with rhuEPO, large prospective studies with long-term follow-up are warranted to verify the results in future. Abbreviations RBC: red blood cell; HD: hemodialysis; rhu EPO: recombinant human erythropoietin; ESRD: end-stage renal disease; EPO: erythropoietin; ROS: reactive oxygen species; CKD: chronic kideny disease; ESAs: erythropoiesis-stimulating agents; HIF-PHD: hypoxia-inducible factor prolyl hydroxylase; CO: carbon monoxide; Hb: hemoglobin.
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    • Contributed Indexing:
      Keywords: Levitt’s CO breath test; Renal anemia; hemodialysis; red blood cell lifespan; roxadustat
    • Accession Number:
      0 (Hemoglobins)
      0 (Isoquinolines)
      64FS3BFH5W (Epoetin Alfa)
      TE7660XO1C (Glycine)
      X3O30D9YMX (roxadustat)
    • Publication Date:
      Date Created: 20211018 Date Completed: 20220126 Latest Revision: 20220427
    • Publication Date:
      20250114
    • Accession Number:
      PMC8525968
    • Accession Number:
      10.1080/0886022X.2021.1988968
    • Accession Number:
      34657570