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Chronic kidney disease-associated anemia occurs due to low production of erythropoietin. The routine standard of care for anemia is erythropoietin and IV iron. Recently, a new oral drug was approved for management of CKD anemia- Desidustat, belonging to class HIF-PHIs that endogenously produces erythropoietin. This study was aimed to seeing real-world experience with Desidustat.
Patients diagnosed with CKD anemia, with or without erythropoietin therapy were given desidustat. Desidustat was given at a dose of 100 mg three times weekly, and patients were followed up monthly to check for a rise in Hb. Dose adjustment was done according to the Hb levels in patient.
In the current study, 52 patients were enrolled. In this study, the majority of patients are pre-dialysis (n=52, 86.53%) and (n= 7, 13.46%) are dialysis-dependent; of dialysis-dependent patients (n=5, 71.42%) on 3/week dialysis treatment. In present study Diabetic kidney disease (DKD) was the most common cause of CKD (n = 34, 65.38%), Hypertension ( n=15, 28.85%), ADPKD (n=2, 3.85%) and FSGS in one case. Of 34 DKD patients, 6 (17.64%) are suffering from proliferative diabetic retinopathy. As a part of CKD Anemia treatment (n=20, 38.46%) patient received IV iron, and (n=13, 25%) received eryhtropoetin. Patients received Desidustat 100 mg thrice daily (n= 41, 78.85%), 50 mg thrice weekly (n=10, 19.23%) and one patients required 150 mg thrice weekly. Tolerability to the desidustat therapy is very good (n=49,94.23%) of 52 patients, three patients didn’t maintained compliance 1 had constipation and throat pain no other an adverse event was observed. In our study we observed significant improvement in Hb level post baseline 1.19 gm/dl (p<0.05, paired t Test). Majortiy of patients remain stable with 100 mg dose of desidustat. However, some (n=9, 17.30%) patients required dose change; of this (n=6, 12%), required dose reduction, (n=2, 4%) required dose increase and 1 patients didn’t responded to desidustat treatment lead to treatment stoppage. Rise of Hb in current study with Desidustat is stable showed increasing trend.
Desidustat significantly increase the Hb in CKD Anemia without causing severe adverse drug reaction. More studies are required to assess the long term efficacy and safety of Desidustat in DD- CKD patients.