Efficacy of Desidustat in Patients with Dialysis-Dependent CKD with Functional Iron Deficiency and High Ferritin

Background: This study evaluated Desidustat (Oxemia®) for managing anemia and reducing elevated hepcidin levels in DD-CKD patients, where hepcidin impairs iron sequestration and absorption. Methods: This is single center study evaluated Desidustat's efficacy in DD-CKD patients with ferritin ≥700 ng/m Patients received Desidustat at 100 mg TIW, with dose increased to 150 mg in 9 patients based on clinical response. Iron indices, including S.ferritin,TIBC, TSAT, S.iron, and hepcidin, monitored baseline Feb 2024, and monthly until Aug 2024. Hb levels were monitored to assess the hematologic response. Results: 27 patients (M:F = 2:1) were enrolled; mean age was 60.5 ± 13 years. Hb levels improved initially and remained steady thereafter. Significant reductions were observed in S.ferritin levels from 1085.83 ng/ml in Feb 2024 to 789.14 ng/ml in Aug 2024 (p=0.003). Hepcidin,also decreased significantly from 64.60 ng/ml to 54.87 ng/ml (p=0.027). Other iron parameters, including serum iron, TIBC, and TSAT, showed non-significant changes. In corelation analysis it showed Serum Iron and TSAT Strong positive correlation which is expected, Ferritin and Hepcidin Moderate positive correlation which suggests a biological link, though not statistically strong due to small smaple size. (Fig 1) Patients maintained good compliance with the therapy. Conclusion: Desidustat effectively reduced hepcidin levels in DD-CKD patients with high-ferritin, suggesting its potential to improve iron utilization and manage anemia in this challenging patient population.