Mymensingh Med J. 2026 Jul;35(3):741-750.
ABSTRACT
Anemia is a common complication of chronic kidney disease (CKD), particularly in patients with stage 5 disease and is associated with increased morbidity and mortality. This retrospective cohort study compared the effectiveness and short-term safety of Roxadustat versus erythropoietin (EPO) for the management of anemia among patients with CKD stage 5. Medical records of 198 adult patients were reviewed, including 99 patients treated with Roxadustat and 99 matched patients treated with EPO, matched 1:1 by age, sex and baseline hemoglobin level. Changes in hemoglobin, hematocrit, iron profile and adverse events over a three-month period were analyzed. Baseline hemoglobin levels were comparable between the Roxadustat and EPO groups (8.62±0.74 vs. 8.59±0.71 g/dL; p=0.756). At three months, mean hemoglobin increased significantly in both groups; however, the mean hemoglobin increase was greater in the Roxadustat group (2.21±0.34 g/dL) compared with the EPO group (2.04±0.37 g/dL; p=0.001). Absolute hemoglobin levels at three months did not differ significantly between groups (10.82±0.85 vs. 10.61±0.76 g/dL; p=0.071). Hematocrit at three months was slightly higher in the Roxadustat group (32.4±2.51% vs. 29.92±2.42%; p<0.001). Roxadustat-treated patients demonstrated favorable iron utilization, with higher transferrin saturation (26.0±6.2% vs. 24.0±6.1%; p<0.029) and serum ferritin levels (551±118.3 vs. 591±136 ng/mL; p=0.033) compared with the EPO group. A higher proportion of patients in the Roxadustat group achieved a hemoglobin level ≥10 g/dL (74.8% vs. 64.6%), although this difference was not statistically significant (p=0.122). The incidence of adverse events, including hypertension, electrolyte abnormalities, infections, headache, edema, thrombosis, seizure etc were comparable between the two groups (p>0.05 for all). In conclusion, Roxadustat was associated with increase in mean hemoglobin and more favorable iron metabolism parameters compared with erythropoietin, while demonstrating a similar short-term safety profile. These findings suggest that Roxadustat may represent a viable alternative to conventional erythropoiesis-stimulating agent therapy for the management of anemia in patients with CKD.
PMID:42375043