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

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 recombina...

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Autores principales: Xiaowei Yang, Bing Zhao, Jing Wang, Lei Wang, Min Tao, Jing Lu, Jiangong Lin, Jing Sun, Rong Wang
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Lenguaje:EN
Publicado: Taylor & Francis Group 2021
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spelling oai:doaj.org-article:860b9687fd1a4d669fcb4f97bae53a002021-11-04T15:00:41ZRed blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin0886-022X1525-604910.1080/0886022X.2021.1988968https://doaj.org/article/860b9687fd1a4d669fcb4f97bae53a002021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/0886022X.2021.1988968https://doaj.org/toc/0886-022Xhttps://doaj.org/toc/1525-6049Introduction 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: hemoglobinXiaowei YangBing ZhaoJing WangLei WangMin TaoJing LuJiangong LinJing SunRong WangTaylor & Francis Grouparticlerenal anemiahemodialysisred blood cell lifespanlevitt’s co breath testroxadustatDiseases of the genitourinary system. UrologyRC870-923ENRenal Failure, Vol 43, Iss 1, Pp 1428-1436 (2021)
institution DOAJ
collection DOAJ
language EN
topic renal anemia
hemodialysis
red blood cell lifespan
levitt’s co breath test
roxadustat
Diseases of the genitourinary system. Urology
RC870-923
spellingShingle renal anemia
hemodialysis
red blood cell lifespan
levitt’s co breath test
roxadustat
Diseases of the genitourinary system. Urology
RC870-923
Xiaowei Yang
Bing Zhao
Jing Wang
Lei Wang
Min Tao
Jing Lu
Jiangong Lin
Jing Sun
Rong Wang
Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
description 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
format article
author Xiaowei Yang
Bing Zhao
Jing Wang
Lei Wang
Min Tao
Jing Lu
Jiangong Lin
Jing Sun
Rong Wang
author_facet Xiaowei Yang
Bing Zhao
Jing Wang
Lei Wang
Min Tao
Jing Lu
Jiangong Lin
Jing Sun
Rong Wang
author_sort Xiaowei Yang
title Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
title_short Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
title_full Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
title_fullStr Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
title_full_unstemmed Red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
title_sort red blood cell lifespan in long-term hemodialysis patients treated with roxadustat or recombinant human erythropoietin
publisher Taylor & Francis Group
publishDate 2021
url https://doaj.org/article/860b9687fd1a4d669fcb4f97bae53a00
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