Liu Jie, Zhou Kefan, Meng Chen, Liu Zhuzhu, Huang Ruihua, Waheed Yousuf, Yang Fan, Liu Kun, Zhao Jiaqi, Zhang Lin, Yu Xiaoyan, Li Shuang, Li Tianyu, Tong Yanshan, Wei Xiaodan, Tian Chuankuo, Sun Dong, Zhou Xinglei
Department of Nephrology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou , China.
Kangda College of Nanjing Medical University, Lianyungang, China.
PLoS One. 2025 Mar 26;20(3):e0320536. doi: 10.1371/journal.pone.0320536. eCollection 2025.
The COVID-19 pandemic has made treating renal anemia in chronic kidney disease (CKD) patients undergoing peritoneal dialysis (PD) difficult. The current study aims to compare roxadustat with erythropoiesis-stimulating agents (ESAs) during the COVID-19 pandemic.
We conducted a single-center, retrospective study during the COVID-19 outbreak in China, from December 7, 2022, to January 31, 2023. The study involved patients undergoing PD who were divided based on the medication used to treat renal anemia; the roxadustat group (n = 34) and the ESAs group (n = 120). We analyzed the effectiveness of treating anemia, cost, medication adherence, and clinical outcomes related to COVID-19. Patients were followed up for 9 months.
The baseline of hemoglobin levels was (110.03 ± 1.71 g/L in the roxadustat and 110.1 ± 1.52 g/L in the ESAs groups, respectively), after 9 months of inspections, the levels of hemoglobin were (121.26 ± 2.03 g/L in the roxadustat and 118.49 ± 1.35 g/L in the ESAs groups, respectively). The roxadustat subgroup analysis indicated that total cholesterol and low-density lipoprotein levels in the roxadustat group decreased from baseline in subjects not receiving statins (3.39 ± 0.12 vs. 4.2 ± 0.21 mmol/L and 2.21 ± 0.23 vs. 3.65 ± 0.37 mmol/L, P < 0.05). The Morisky score of the roxadustat group was higher [7 (5, 8) vs. 6 (4, 8), P < 0.01]. The drug cost of the roxadustat group was higher, but another additional cost for correcting anemia was significantly reduced. The infection rate of COVID-19 and the mortality rate caused by COVID-19 were lower in roxadustat group.
During the COVID-19 pandemic, both roxadustat and ESAs effectively improved renal anemia in PD patients, however, the roxadustat group experienced less additional costs for anemia correction and better medication compliance.
新型冠状病毒肺炎（COVID - 19）大流行使得对接受腹膜透析（PD）的慢性肾脏病（CKD）患者进行肾性贫血治疗变得困难。本研究旨在比较COVID - 19大流行期间罗沙司他与促红细胞生成素（ESA）的疗效。
我们在中国COVID - 19疫情期间进行了一项单中心回顾性研究，时间为2022年12月7日至2023年1月31日。该研究纳入了接受PD治疗的患者，根据治疗肾性贫血所用药物将患者分为两组；罗沙司他组（n = 34）和ESA组（n = 120）。我们分析了治疗贫血的有效性、成本、用药依从性以及与COVID - 19相关的临床结局。对患者进行了9个月的随访。
血红蛋白水平基线分别为（罗沙司他组110.03 ± 1.71 g/L，ESA组110.1 ± 1.52 g/L），经过9个月的观察，血红蛋白水平分别为（罗沙司他组121.26 ± 2.03 g/L，ESA组118.49 ± 1.35 g/L）。罗沙司他亚组分析表明，未接受他汀类药物治疗的罗沙司他组患者的总胆固醇和低密度脂蛋白水平较基线下降（3.39 ± 0.12 vs. 4.2 ± 0.21 mmol/L以及2.21 ± 0.23 vs. 3.65 ± 0.37 mmol/L，P < 0.05）。罗沙司他组的Morisky评分更高[7（5，8）vs. 6（4，8），P < 0.01]。罗沙司他组的药物成本更高，但纠正贫血的额外成本显著降低。罗沙司他组的COVID - 19感染率和COVID - 19导致的死亡率更低。
在COVID - 19大流行期间，罗沙司他和ESA均能有效改善PD患者的肾性贫血，然而，罗沙司他组在贫血纠正方面的额外成本更低，用药依从性更好。
