Introduction:
Anemia is a frequent complication of CKD, which is associated with a heightened risk of Cardiovascular mortality and decreased quality of life. Anemia can independently influence rate of fall in GFR and can cause faster progression of CKD. The current consensus in the treatment of Anemia in CKD is intravenous/oral iron and erythropoietin stimulating agents/analogues. Desidustat is an orally bioavailable, Hypoxia-inducible factor-prolyl hydroxylase inhibitor which stimulates endogenous erythropoietin production and erythropoiesis. Hence, this study is aimed to study the outcomes of Desidustat in CKD patients with anemia at our centre.
Methods:
This is a retrospective observational study in which we analysed a cohort of 30 patients. They were administered Desidustat 100mg on alternate day along with oral iron (ferric pyrophosphate/Heme iron polypeptide), at our centre, with an average follow-up of patients around 8 weeks at our Nephrology OPD.
Results:
In the current study, total study subjects were 30, of which 67% were males and 33% were females. 11 patients were on dialysis, 18 were pre-dialysis patients and 1 was post-transplant. 83% of our study subjects were Diabetic and 9 patients had pre-existing diabetic retinopathy. In 7 patients who reached hemoglobin > 11g%, dose of Desidustat was reduced to 75mg and 50mg alternate day subsequently. The baseline mean hemoglobin in the study group was 8.3±1 gm/dl. An increase in hemoglobin from baseline to 4 weeks was observed, reaching 9.3±0.82gm/dl. This rise in hemoglobin was statistically significant(p<0.0087). At second follow up, around 8 weeks, hemoglobin level improved to 10.07±1.43gm/dl which was statistically significant (p<0.0001). Subsequently, 8 subjects had a long-term follow-up till 4 months, whose mean hemoglobin reached 11±1.02gm/dl which was a significant improvement compared to their baseline hemoglobin (p<0.0001). Only 3 out of 30 patients required intravenous iron along with oral supplementation. Overall, patients who received Desidustat showed an increase of 1.8g/dl at the end of 8 weeks and about >2.5g/dl at the end of 4 months in their hemoglobin levels demonstrating its significance in the treatment of anemia in CKD patients. 95% of the study group showed good compliance. Adverse events were noted in 4 patients like, iron overload(n=1), ACS-NSTEMI(n=1), atrial fibrillation(n=1), worsening of retinopathy requiring both eye laser therapy(n=1).
Conclusions:
Desidustat demonstrated a substantial improvement in hemoglobin levels in patients with CKD-anemia. Good compliance of the drug was observed, attributed to its oral administration. Long- term prospective studies with larger population and prospective comparative studies with use of other erythropoietin stimulating agents are recommended to further assess the safety and efficacy outcomes of Desidustat in CKD-anemia patients.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.