■缺氧诱导因子-脯氨酸酰羟化酶抑制剂(HIF-PHIs)是用于肾性贫血治疗的新型口服药剂。Roxadustat,一流的HIF-PHI用于治疗慢性肾病患者的贫血,已在中国获得批准,Japan,韩国,智利,和欧洲。Roxadustat参与HIF降解,可以刺激内源性促红细胞生成素(EPO)的产生并提高铁的利用率。此外,罗沙司他能促进膳食铁的摄取和运输。与传统的红细胞生成刺激剂治疗相比,它可能会降低心血管风险和死亡率,因为它只会导致血浆EPO水平略有增加。II期和III期临床试验报告表明,罗沙司他可有效治疗慢性肾脏病患者。需要检查罗沙司他在肾移植受者(KTR)中的作用,因为慢性肾脏疾病患者与接受肾移植的患者不同。
临床试验表明,罗沙司通过刺激内源性EPO产生和优化铁利用,有效地增加和维持透析依赖性和非透析依赖性慢性肾病患者的血红蛋白水平。Roxadustat最近已有效用于治疗EPO抗性贫血患者。它也被用于治疗移植后贫血(PTA)的患者,这是铁缺乏和肾小球滤过率受损的KTRs死亡率的预后因素。这里,我们在叙述性回顾中审查了四项研究的结果,并讨论了我们对这一研究领域的看法。
■Roxadustat显着改善了带有PTA的KTR的血红蛋白水平而不影响肾功能。它还通过降低铁蛋白和铁调素水平和增加总铁结合能力来提高铁利用率。转铁蛋白,和血清铁水平。Roxadustat改善贫血和炎症,并可能在KTRs中具有肾脏保护作用。
UNASSIGNED: Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are novel oral agents used for renal anemia treatment. Roxadustat, a first-in-class HIF-PHI used for treating anemia in chronic kidney disease patients, has been approved in China, Japan, South Korea, Chile, and Europe. Roxadustat is involved in HIF degradation, which can stimulate endogenous erythropoietin (EPO) production and improve iron utilization. Besides, roxadustat can promote dietary iron uptake and transport. In comparison with traditional erythropoiesis-stimulating agent treatment, it might reduce cardiovascular risk and mortality as it causes only a slight increase in the plasma EPO level. Phase II and III clinical trial reports have shown that roxadustat is effective for treating chronic kidney disease patients. The role of roxadustat in kidney transplant recipients (KTRs) needs to be examined as patients with chronic kidney disease are different from those receiving renal transplants.
UNASSIGNED: Clinical trials have demonstrated that roxadustat effectively increases and maintains hemoglobin levels in patients with dialysis-dependent and non-dialysis-dependent chronic kidney disease by stimulating endogenous EPO production and optimizing iron utilization. Roxadustat has recently been used effectively to treat patients with EPO-resistant anemia. It has also been used for treating patients with posttransplant anemia (PTA), which is a prognostic factor for mortality in KTRs with an iron deficiency and impaired glomerular filtration rate. Here, we examined the findings of four studies in a narrative
review and discussed our perspectives regarding this field of study.
UNASSIGNED: Roxadustat significantly improves hemoglobin levels without affecting renal function in KTRs with PTA. It also enhances iron utilization by decreasing ferritin and hepcidin levels and increasing total iron binding capacity, transferrin, and serum iron levels. Roxadustat ameliorates anemia and inflammation, and might have reno-protective effects in KTRs.