罗沙司他与血液透析患者铜升高和甲状腺功能减退的关联。

Associations of roxadustat with copper elevation and hypothyroidism in patients on hemodialysis.

作者信息

Aoki Shugo, Saito Tomohiro, Yoshida Shunsuke, Shibagaki Keigo, Hirao Keiichi, Yuza Toshiki, Honda Hirokazu

机构信息

Department of Nephrology, Showa Medical University Graduate School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8666, Japan.

Shibagaki Clinic Jiyugaoka, Tokyo, Japan.

出版信息

Int Urol Nephrol. 2025 Aug 29. doi: 10.1007/s11255-025-04759-w.

DOI:10.1007/s11255-025-04759-w

PMID:40883653

Abstract

BACKGROUND

This study aimed to assess the associations of roxadustat with changes in serum trace element levels and with hypothyroidism in hemodialysis (HD) patients.

METHODS

A total of 34 patients on HD who received weekly doses of darbepoetin-α or a continuous erythropoietin receptor activator once every 2 or 4 weeks were switched to roxadustat (70 mg, three times weekly). Levels of biomarkers for erythropoiesis and iron metabolism, trace elements (copper, zinc, and selenium), ceruloplasmin, and thyroid-stimulating hormone (TSH), free-triiodothyronine (T3), and free-tetraiodothyronine (T4) were measured in blood samples collected before the HD session on days 0 (switch to roxadustat treatment), 28, and 56.

RESULTS

Serum copper and ceruloplasmin levels were significantly increased by roxadustat treatment on days 28 and 56, and serum selenium levels were lower on day 28. However, serum zinc levels were not changed over the 56 days. Serum TSH levels were decreased on day 28, and they then increased to baseline on day 56. Serum free-T3 and free-T4 levels were significantly decreased from day 28 to day 56. Changes in roxadustat doses were associated with changes in serum TSH, free-T3, and free-T4 levels, whereas they were not associated with serum levels of trace elements.

CONCLUSIONS

Roxadustat may decrease serum TSH, free-T3, and free-T4 levels and increase serum copper and ceruloplasmin levels in HD patients.

摘要

背景

本研究旨在评估罗沙司他与血液透析（HD）患者血清微量元素水平变化及甲状腺功能减退之间的关联。

方法

共有34例接受每周一次达贝泊汀-α或每2或4周一次连续促红细胞生成素受体激活剂治疗的HD患者改用罗沙司他（70毫克，每周三次）。在第0天（改用罗沙司他治疗）、第28天和第56天血液透析治疗前采集的血样中，检测促红细胞生成和铁代谢的生物标志物、微量元素（铜、锌和硒）、铜蓝蛋白以及促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（T3）和游离甲状腺素（T4）的水平。

结果

罗沙司他治疗在第28天和第56天显著提高了血清铜和铜蓝蛋白水平，第28天血清硒水平较低。然而，血清锌水平在56天内未发生变化。血清TSH水平在第28天下降，然后在第56天升至基线水平。血清游离T3和游离T4水平从第28天到第56天显著下降。罗沙司他剂量的变化与血清TSH、游离T3和游离T4水平的变化相关，而与微量元素的血清水平无关。