低剂量罗沙司他治疗老年非透析慢性肾脏病贫血的临床观察

Low-dose roxadustat in the treatment of renal anemia in elderly patients with non-dialysis chronic kidney disease

目的 观察低剂量罗沙司他治疗老年非透析慢性肾脏病3~5期贫血的临床疗效和安全性。方法 回顾性分析2021年5月至10月在北京大学第三医院肾内科门诊就诊的老年非透析慢性肾脏病3~5期贫血患者,所有患者均首次服用罗沙司他且未使用过促红细胞生成素治疗,服用罗沙司他剂量均是低起始剂量(50~70 mg/次)。资料收集包括患者一般情况、使用罗沙司他治疗前和治疗后12周贫血相关指标、生化学指标、炎症指标以及不良反应。结果共纳入43例老年非透析慢性肾脏病3~5期贫血患者,年龄(76.6±8.9)岁,41.9%的患者年龄≥80岁。低剂量罗沙司他治疗前血红蛋白(HGB)(90.9±14.9)g/L,治疗12周HGB(107.0±14.2)g/L,罗沙司他治疗后HGB明显升高,差异具有统计学意义(P<0.001),65%的患者HGB≥110 g/L。12周罗沙司他治疗过程中共有3例患者(6.97%)出现不良反应,无一例出现药物严重不良反应停药。结论 低剂量罗沙司他治疗老年非透析慢性肾脏病贫血的临床疗效良好且安全性较高。

Objective To observe clinical efficacy and safety of low-dose roxadustat in the treatment of renal anemia in elderly patients with non-dialysis stage 3-5 chronic kidney disease(CKD). Methods A retrospective analysis was performed in elderly patients with renal anemia in the department of nephrology,Peking University Third Hospital from May to October 2021. All patients were taking roxadustat for the first time and had not been treated with erythropoietin,and the initial dose of roxadustat(50-70 mg)was lower compared to recommended dose. The observation period was 12 weeks. The data collected included general status, the anemia-related indicators, biochemical indicators, inflammatory indicators before using roxadustat and 12 weeks after treatmentand adverse reactions. Results A total of forty-three elderly patients with non-dialysis CKD(stage 3-5)were included in this study with an average age of(76.6 ± 8.9)years old and 41.9% of patients aged≥80 years. We found HGB of elderly CKD patients was significantly increased after 12 weeks of roxadustat treatment. The patients HGB increased from(90.9±14.9)to(107.0±14.2)g/L(P <0.001)and 65% of patients with HGB≥110 g/L. During 12 weeks of roxadustat treatment,a total of 3 patients(6.97%)experienced adverse reactions and no patients stopped the treatment due to serious adverse reactions. Conclusion Low-dose roxadustat in the treatment of renal anemia in elderly patients with non-dialysis chronic kidney disease is effective and safe.