罗沙司他治疗老年非透析慢性肾脏病肾性贫血的疗效观察

Effect of Roxadustat on Renal Anemia in Elderly Patients with Non-dialysis Chronic Kidney Disease

目的:观察罗沙司他治疗老年(≥65岁)非透析慢性肾脏病(CKD)肾性贫血的临床疗效和安全性。方法:筛选使用罗沙司他治疗的老年非透析CKD患者,收集患者一般情况、使用罗沙司他治疗前后贫血相关指标、铁代谢和脂代谢指标,以及药物不良反应。结果:(1)共纳入58例,年龄76.0(69.0,83.0)岁。治疗3个月后Hb、RBC及Hct显著升高(P<0.001),SF显著下降(P<0.05),TIBC显著升高(P<0.05),而TSAT及SI较基线无显著改变(P>0.05)。(2)补充铁剂组Hb升高幅度、Hb应答率均显著高于未补充铁剂组(P<0.05)。(3)治疗前后血钾水平及高钾血症发生率差异无统计学意义(P>0.05)。结论:小剂量罗沙司他可显著改善老年非透析CKD患者肾性贫血状态,同时口服铁剂有助于纠正贫血;罗沙司他未显著增加高钾血症发生率。

Objective:To investigate clinical efficacy and safety of roxadustat on renal anemia in elderly patients with non-dialysis chronic kidney disease(NDD-CKD).Methods:NDD-CKD patients(age≥65 years)treated with roxadustat were enrolled.The changes of laboratory parameters before and after roxadustat treatment were analyzed retrospectively.Results:(1)A total of fifty-eight patients were included in this study with an average age of 76.0(69.0,83.0)years old.After 3 months of treatment,Hb,RBC and HCT increased significantly(P<0.001);SF decreased significantly(P<0.05),TIBC increased significantly(P<0.05),but TSAT and SI did not change significantly(P>0.05).(2)The mean change from baseline in Hb level and Hb response rate in iron supplementation group were significantly higher than those in non-iron supplementation group(P<0.05).(3)There was no significant difference in serum potassium level and incidence of hyperkalemia before and after treatment(P>0.05).Conclusion:Low-dose roxadustat significantly improved renal anemia in elderly patients with NDD-CKD,while oral iron therapy helped to correct the anemia.Roxadustat did not increase the incidence of hyperkalemia.