| Objective:To understand the elements influencing the efficacy of Roxadustat in the treatment of maintenance hemodialysis(MHD)patients with renal anemia,and to establish a predictive model for the efficacy of Roxadustat to guide the selection of clinical drugs.Methods:A total of 111 patients with MHD diagnosed with renal anemia and treated with Roxadustat from January 1,2021 to December 31,2022 in the blood purification room of our hospital and the First Affiliated Hospital of Nanchang University were selected.The patients’ general information,blood routine,and blood biochemical indexes were collected from the patients’ electronic medical records,and they were divided into effective and ineffective groups according to the change in hemoglobin after 3 months of treatment.The survey results of the two groups were compared for retrospective analysis,and the independent factors affecting the efficacy of Roxadustat were obtained using logistic regression analysis,and the efficacy prediction model was constructed to evaluate the predictive value of the model.Results:1.A total of 111 patients were included in the survey,including 79 males(71.17%)and 32 females(28.83%),with an average age of 59.25 ±14.82.The average hemoglobin levels before treatment were 96.18 ±18.048,after 3 months of treatment,hemoglobin rises to 107.69 ±19.881,and there were 70 cases(63.06%)in the effective group and 41 cases(36.94%)in the ineffective group.2.Univariate analysis showed that there were significant differences in sex,primary disease,diabetes mellitus,combined hemofiltration and/or hemoperfusion therapy,dialysis age,Kt/v,URR,hemoglobin,hematocrit,potassium,and total calcium in the effective group compared with the ineffective group.(P<0.05).3.Combined with univariate analysis,sex,dialysis age,a combination of hemofiltration and/or hemoperfusion therapy,diabetes mellitus,Kt/v,URR,hemogl-obin,potassium and total calcium were included in the logistic regression analysis.The results showed that sex,diabetes mellitus,combined hemofiltration and/or hemoperfusion therapy,and Kt/v were independent factors affecting the efficacy of Roxadustat in patients with maintenance hemodialysis.4.The curative effect prediction model was established based on the four independent indexes obtained by multi-factor logistic regression analysis,and the model had good predictive value,in which AUC was 0.796(95% CI 0.712-0.880,P<0.001),sensitivity was 75.7%,specificity was 73.2%,and the best cut-off value was 0.6224.Conclusion:A better therapeutic effect can be obtained by using Roxadustat in the treatment of maintenance hemodialysis patients with renal anemia.Among them,gender,diabetes mellitus,combined hemofiltration and/or hemoperfusion therapy,and Kt/v are independent factors affecting the efficacy of Roxadustat.In future work,we need to take an appropriate intervention,such as strengthening patients’ health education,and ncreasing the rate of hemofiltration and/or hemoperfusion therapy,so /as to improve the efficiency of Roxadustat treatment as much as possible. |
