| Objective: 1.To compare the efficacy of roxadustat and recombinant human erythropoietin in the treatment of renal anemia in maintenance hemodialysis patients.2.To analyze the effect of roxadustat and recombinant human erythropoietin on the variability of hemoglobin and its relationship with prognosis.Methods: A retrospective collection of 67 maintenance hemodialysis(Maintenance hemodialysis,MHD)patients with renal anemia who met the inclusion criteria in the nephrology ward and outpatient clinic of the Affiliated Hospital of Inner Mongolia Medical University from December 2021 to December 2022 were collected.According to different treatment plans,they were divided into two groups: Roxadustat group(n=30)and recombinant human erythropoietin(rHuEPO)group(n=37).Collect clinical data of patients,including demographic data,laboratory test results;blood routine and iron metabolism data before treatment and after 12 weeks of treatment;complete blood red blood cell count level every 1-3 months,etc.Follow-up patients from enrollment to Patients died,terminated hemodialysis,transferred kidney transplantation,transferred to other centers,lost follow-up,occurred study endpoint events or reached the study termination date.The dosage should be appropriately adjusted according to the instructions for use of roxadustat or rHuEPO and the level of hemoglobin(Hb),age and body weight of the patient at the time of consultation.The average follow-up time was 1 year.SPSS 26.0 statistical software was used for statistical analysis of the data,and the statistical methods of t test,nonparametric test,2 test and logistic regression analysis were used to compare roxadustat and recombinant human erythropoietin in the treatment of maintenance hemodialysis patients.To analyze the effect of two types of drugs on hemoglobin variability(Hb-Var)in patients with MHD,and then explore the relationship with prognosis.4.Adverse reactions: During the follow-up period,the adverse reactions in the two groups were mainly heart failure.The incidence of adverse events in the Roxadustat group was lower than that in the rHuEPO group,and there was no significant difference between the two groups(P>0.05).5.Hemoglobin variability: 4 calculation methods were used to evaluate the hemoglobin variability.There were hemoglobin fluctuations in the two groups of patients during drug treatment,but the individual hemoglobin average value and its standard deviation,amplitude,coefficient of variation and difference of the two groups of patients There was no statistically significant difference in the mean values(P>0.05).6.Prognosis: A total of 23 cases of cardiovascular and cerebrovascular clinical adverse events occurred during the observation period,and no variables related to hemoglobin variability that had a significant impact on adverse prognosis were found,and the difference was not statistically significant(P>0.05).Results: 1.Sixty-seven patients with maintenance hemodialysis combined with renal anemia who met the inclusion criteria were divided into Roxadustat group and rHuEPO group,and compared the baseline characteristics of the two groups,it was found that the levels of total cholesterol(TC)and high-density lipoprotein(HDL)in the rHuEPO group were higher than those in the Roxadustat group,and the difference was statistically significant(P <0.05)。There was no significant difference in age,sex,Body mass index(BMI),primary cause,etc.and other laboratory biochemical indexes before treatment,such as parathyroid hormone(PTH),albumin(Alb),serum calcium(Calcium,Ca),C-reactive protein(CRP),etc.(P>).0.05)。2.Anemia-related indicators: after 12 weeks of treatment,two groups of patients with red blood cells(RBC),hemoglobin,hematocrit(HCT),red cell volume distribution width SD(RDW-SD),mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin content concentration(MCHC)were higher than those before treatment,and the difference was statistically significant(P<0.05).The changes in hemoglobin,hematocrit and mean corpuscular volume(MCV)in the Roxadustat group were higher than those in the rHuEPO group,and the differences between the groups were statistically significant(P <0.05)。3.Iron metabolism-related indexes: the levels of transferrin saturation(TSAT),ferritin(SF),serum iron(Ferrum,Fe)and total iron binding capacity(TIBC)were increased compared with those before treatment after 12 weeks of treatment in the two groups,and the difference was statistically significant(P<0.05);The levels of change before and after the intervention of Fe and TIBC in the Roxadustat group were higher than those in the rHuEPO group,and the difference between the groups was statistically significant(P<0.05).Conclusion: 1.Both roxadustat and rHuEPO are effective in the treatment of renal anemia in maintenance hemodialysis patients,and the efficacy of roxadustat is better than that of rHuEPO,which can significantly correct the symptoms of anemia and increase the body’s absorption and utilization of iron.2.Roxadustat and rHuEPO have no significant difference in the degree of influence on Hb-Var in correcting renal anemia,and there is no significant correlation between hemoglobin variability and poor prognosis. |
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