Single-Center 1-Year Experience with the Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor Desidustat (Oxemia) in Dialysis- and Nondialysis-Dependent Patients with CKD and Anemia

Background: Chronic Kidney Disease (CKD)-induced anemia results from a deficiency of erythropoietin. Recently, Desidustat, a HIF-PHI, approved in India, has shown promise in correcting anemia in both dialysis-dependent and non-dialysis-dependent CKD patients. This study presents a retrospective analysis of Desidustat usage in CKD anemia patients. Methods: This retrospective analysis was conducted at BLK Max Hospital, New Delhi. Patients diagnosed with CKD received Desidustat at doses of 100 mg,thrice weekly, with regular monitoring of hemoglobin levels. Subjects with diabetic nephropathy, ADPKD, and a history of malignancy were excluded. The Desidustat dose was adjusted to maintain hemoglobin levels of 11-12 gm/dL. Results: We enrolled 45 patients: 17 (37.7%) with CKD stage 3, 5 (11.1%) with CKD stage 4, 12 (26.6%) with CKD stage 5, and 11 (24.4%). Of these, 24 (53.4%) were male and 21 (46.6%) female. The majority (34, 75.5%) were non-dialysis-dependent, while 11 (24.4%) were dialysis-dependent. Hypertension was present in 40 (88.8%), diabetes in 11 (24.4%), hypothyroidism in 8 (17.7%), and hyperthyroidism in one patient. All patients received Desidustat thrice weekly with intravenous iron supplementation. Most patients (43, 95.5%) received 100 mg, one patient received 125 mg (2.2%), and another 150 mg (2.2%). The mean serum creatinine was 4.48 ± 1.28 mg/dL, eGFR was 23.17 ± 8.13 mL/min/1.73m2, and mean transferrin saturation (TSAT) was 21.21 ± 9.65%. The mean baseline hemoglobin was 10.28 ± 1.8 g/dL, which increased to 13.5 ± 1.7 g/dL by the end of the study (p<0.05, one-way ANOVA). Compliance with Desidustat was high, and no thrombosis, fistula failure, treatment failure, or hyperkalemia associated with HIF-PHI treatment was observed. Mild adverse events such as decreased appetite, vomiting, and generalized body weakness were transient and self-resolved. Conclusion: Desidustat showed promising outcomes in improving hemoglobin levels in CKD-related anemia. Long-term data suggest that Desidustat is a safe alternative to erythropoietin analogues.p<0.05