Department of Nephrology, Provincial Hospital affiliated to Shandong First Medical University, Jinan, PR China.
Department of Nephrology, Caoxian People's Hospital, Heze, PR China.
Ren Fail. 2021 Dec;43(1):1428-1436. doi: 10.1080/0886022X.2021.1988968.
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.
RBC lifespan was measured by Levitt's CO breath test with newly developed automatic instrument ELS Tester.
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 ( < .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 ( = -0.087, = .500) or weekly roxadustat dosage ( = -0.267, = .110) in our cohort.
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. 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.
肾衰竭患者的红细胞（RBC）存活率显著下降，这被认为是导致肾性贫血的原因之一。本观察性研究的目的是确定与健康人相比，接受罗沙司他或重组人促红细胞生成素（rhuEPO）治疗的血液透析（HD）患者的 RBC 存活率。
使用新开发的自动仪器 ELS Tester 通过 Levitt 的 CO 呼气试验测量 RBC 寿命。
本研究共纳入来自两个独立透析中心的 102 名长期接受 HD 治疗的患者，其中 62 名接受 rhuEPO 治疗，40 名接受罗沙司他治疗。共招募了 25 名健康参与者与 HD 参与者按年龄和性别相匹配。rhuEPO、罗沙司他和对照组的 RBC 生存时间中位数分别为 65.0（25 至 75 百分位数，49.5 至 77.3）、75.5（25 至 75 百分位数，57.3 至 99.3）和 108.0（25 至 75 百分位数，89.0 至 141.5）天。接受罗沙司他治疗的患者 RBC 生存时间明显长于接受 rhuEPO 治疗的患者（ < .05）。在对整个 HD 患者影响 RBC 寿命的多因素分析中，贫血治疗药物（rhuEPO/罗沙司他）和血红蛋白水平是显著的独立因素。在我们的队列中，RBC 生存时间与每周 rhuEPO 剂量（ = -0.087， = .500）或每周罗沙司他剂量（ = -0.267， = .110）均无相关性。
接受罗沙司他治疗的 HD 患者的 RBC 生存时间明显长于接受 rhuEPO 治疗的患者，需要进行更大规模的前瞻性长期随访研究来验证未来的结果。RBC：红细胞；HD：血液透析；rhu EPO：重组人促红细胞生成素；ESRD：终末期肾病；EPO：促红细胞生成素；ROS：活性氧；CKD：慢性肾脏病；ESAs：促红细胞生成素类药物；HIF-PHD：缺氧诱导因子脯氨酰羟化酶；CO：一氧化碳；Hb：血红蛋白。
