Efficacy of HIF-PHD Inhibitors for Renal Anemia in Peritoneal Dialysis Patients: A Single-Center Retrospective Study

 

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Efficacy of HIF-PHD Inhibitors for Renal Anemia in Peritoneal Dialysis Patients: A Single-Center Retrospective Study

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Genri
Tagami
Genri Tagami tagami.genri.056@mail.aichi-med-u.ac.jp Aichi Medical University Department of Nephrology and Rheumatology Nagakute Japan *
Kazuki Ogasawara 113027ogasawara.kazuki@gmail.com Narita Memorial Hospital Department of Nephrology Toyohashi Japan -
Makoto Yamaguchi yamaguchi.makoto.231@mail.aichi-med-u.ac.jp Aichi Medical University Department of Nephrology and Rheumatology Nagakute Japan -
Kinashi Hiroshi kinashi.hiroshi.909@mail.aichi-med-u.ac.jp Aichi Medical University Department of Nephrology and Rheumatology Nagakute Japan -
Takaaki Obayashi 69990000@meiyokai.or.jp Narita Memorial Hospital Department of Nephrology Toyohashi Japan -
Yasuhiko Ito yasuito@aichi-med-u.ac.jp Aichi Medical University Department of Nephrology and Rheumatology, Nagakute Japan -
Takuji Ishimoto ishimoto.takuji.352@mail.aichi-med-u.ac.jp Aichi Medical University Department of Nephrology and Rheumatology, Nagakute Japan -
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Renal anemia is a common and sometimes difficult-to-manage complication in peritoneal dialysis (PD) patients. Hypoxia-inducible factor prolyl hydroxylase (HIF-PHD) inhibitors are a novel therapeutic option, but data in PD patients remain limited. This study retrospectively evaluated the efficacy of HIF-PHD inhibitors in PD patients who had been switched from erythropoiesis-stimulating agents (ESAs).

This single-center retrospective study was conducted at Narita Memorial Hospital in Aichi, Japan. Among 49 PD patients treated with HIF-PHD inhibitors daprodustat or vadadustat, 15 patients met the inclusion criteria:(1) switched from ESA therapy (patients with prior HIF-PHD inhibitor or without prior ESA use were excluded) and (2) baseline Hb < 11 g/dL. Hemoglobin levels were evaluated monthly for 5 months after initiation. A subgroup analysis was also conducted in patients with baseline Hb < 10 g/dL.

The study included 15 PD patients (7 men, 8 women; mean age, 67 ± 11 years, range 50–87 years). Mean hemoglobin increased from 9.8 ± 0.8 g/dL at baseline to 10.7 ± 1.2 g/dL at month 4, with significant improvements observed at months 3 and 4 (p = 0.0497 and 0.028, respectively).In the subgroup with baseline Hb < 10 g/dL (n = 7) Hb rose from 9.0 ± 0.6 g/dL at baseline to over 10.3 g/dL from month 3 (p = 0.031) onward with significant increases at months 3–5.

PD patients with renal anemia switched from ESA therapy HIF-PHD inhibitors significantly improved hemoglobin levels over 5 months. The improvement was particularly evident among those with baseline Hb < 10 g/dL. These findings support the clinical utility of HIF-PHD inhibitors as an effective alternative to ESA therapy in PD populations though larger prospective studies are warranted.

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