Single-Center, 1-Year Experience of the Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor (HIF-PHI) Desidustat in Dialysis-Dependent Patients with CKD-Related Anemia

Background: Chronic kidney disease-induced anemia is due to relative deficiency of Erythropoietin from kidneys. In the dialysis-dependent category, patient become dependent on erythrocyte-stimulating agents. Newer HIF PHIs showed promise of correcting anemia in dialysis-dependent CKD anemia patients. Our study is a retrospective analysis of usage of HIF PHI in dialysis-dependent patients. Methods: This is a single center retrospective analysis of one year experience at Shrimann hospital, Jalandhar. We enrolled patient who are diagnosed with CKD – Anemia and dialysis dependent at our center. These patients were started on Treatment of Desidustat 100 mg and 50 mg thrice in a week and every monthly their Hemoglobin monitored. Results: In present study, we have enrolled total 58 patients. Out of this 36 (62%) were male and 22 (38%) were female. All patient received dialysis for 3 times in a week. Patient received IV iron according to iron profile. Out of 57 patients, majority had diabetic Kidney Disease (n=42, 73.6%), Hypertension (45, 78.9%), CAD (4, 7%), ADPKD (2, 3.5%) and one case of post-transplant (1, 1.7%), Multiple Myeloma (1,1.7%), IgAN (1,1.7%), Majority of our patient received treatment of Desidustat 100 mg (n=32, 55.2%) and 50 mg (n= 26, 44.8%) for CKD anemia thrice a week. Mena Serum creatinine 7.56 ± 3 mg/ dl and eGFR 8.72 ± 5.7 mL/min/1.73m2. Mean Serum Iron 29.74 ± 46.5 mcg/dl. Baseline Hb at the start of treatment was 8.82 ± 1.8 gm/dl at the end of study Hb was 10.35 ± 1.7 gm/dl (p= 0.002, One way ANOVA) test) showed in Figure 1. Mean difference from baseline observed was 1.53 gm/dl in dialysis dependent patients. In present study al patients maintained good compliance with the treatment of Desidustat. Out of 58 patients, we have not observed any thrombosis of AV fistula or Fistula failure, treatment failure, or hyperkalemia with HIF-PHI treatment. Conclusion: Desidustat showed a promising outcome in terms of improvement of Hb in CKD-anemia. Long-term, one year data showed desidustat is a safe alternative to erythropoietin analogue.