Influencing factors of clinical efficacy of roxadustat among hemodialysis patients

Figures & data

Figure 1. The flowchart of study design.

Table 1. Clinical characteristics of the study population and comparison of characteristics between the two groups.

Clinical characteristics	Total	Nonresponse (n = 38)	Response (n = 29)	p
Male (%)	67%	67%	68%	.918
Age (years)	53.63 ± 13.02	50.49 ± 11.43	58 ± 14.01	.019
Weight (kg)	61.86 ± 12.89	63.86 ± 15.09	59.23 ± 8.83	.122
Height (cm)	166.16 ± 7.47	166.34 ± 7.78	165.93 ± 7.17	.825
BMI (kg/m^2)	22.29 ± 3.78	22.93 ± 4.45	21.46 ± 2.51	.091
Cause of kidney disease (%)
Chronic glomerulonephritis	65.67%	74.36%	53.57%	.091
Diabetic nephropathy	22.39%	15.38%	32.14%
Polycystic kidney	2.99%	0.00%	7.14%
IgA nephropathy	2.99%	2.56%	3.57%
Benign arteriolar nephrosclerosis	4.48%	7.69%	0.00%
ANCA-associated nephritis	1.49%	0.00%	3.57%
Duration of dialysis (months)	28.87 ± 34.86	30 ± 33.55	27.29 ± 37.18	.756
Previous treatment				.257
rhEPO	3%	2.6%	3.6%
rhEPO to roxadustat	13.4%	10.3%	17.9%
Roxadustat	80.6%	87.2%	71.4%
None	3%	0%	7.1%
spKt/V	1.36 ± 0.34	1.36 ± 0.36	1.37 ± 0.31	.965
Red blood cell (g/L)	3.52 ± 0.6	3.56 ± 0.56	3.46 ± 0.65	.528
Hct (L/L)	0.32 ± 0.05	0.32 ± 0.04	0.32 ± 0.06	.709
White blood cell (×10^9/L)	6.06 ± 2.12	5.97 ± 1.89	6.19 ± 2.43	.674
Neutrophils (×10^9/L)	4.17 ± 1.99	4.02 ± 1.57	4.39 ± 2.47	.463
Platelet (×10^9/L)	172.03 ± 56.62	171.87 ± 59.1	172.25 ± 54.04	.979
Lymphocyte (×10^9/L)	1.19 ± 0.42	1.21 ± 0.42	1.17 ± 0.41	.747
Dosage of roxadustat (mg)	300 (210, 300)	300 (150, 300)	300 (270, 360)	.139
Plasma concentration (ng/mL)	521.85 ± 728.71	326.19 ± 345.5	794.39 ± 998.85	.008
Ferritin (ng/mL)	102.29 ± 154.63	72.64 ± 73.42	142.92 ± 217.96	.072
PTH (pg/mL)	361.47 ± 463.98	422.01 ± 552.06	276.25 ± 288.64	.215
Baseline Hb (g/L)	103.24 ± 17.66	109.51 ± 14.7	94.5 ± 17.95	<.001
Oral iron	46%	41%	54%	.31
Hb after 4 weeks (g/L)	103.64 ± 14.35	102.08 ± 14.38	105.5 ± 14.46	.438
Hb after 8 weeks (g/L)	107.26 ± 15.65	102.24 ± 16.68	112.29 ± 13.16	.06

BMI: body mass index; Hct: hematocrit; NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio; PTH: parathyroid hormone; Hb: hemoglobin; rhEPO: recombinant human erythropoietin; spKt/V: single pool Kt/V.

Previous treatment: previous anemia treatment from 3 to 6 months before enrollment.

Figure 2. Receiver operating characteristic curve analysis evaluating the predictive ability of variables. The AUC of the model for predictive power of clinical efficacy was 0.859 (95%CI: 0.763–0.955); the AUC of blood trough concentration for predictive power of clinical efficacy was 0.647 (95%CI: 0.508–0.787); the AUC of age for predictive power of clinical efficacy was 0.64 (95%CI: 0.504–0.776); the AUC of baseline Hb for predictive power of clinical efficacy was 0.76 (95%CI: 0.642–0.897). AUC: area under the curve; Hb: hemoglobin.

Table 2. Univariate and multivariate analyses of influencing factors for clinical efficacy of roxadustat.

	Univariate analyses			Multivariate analyses
	β	OR (95% CI)	p	β	OR (95% CI)	p
Age (yr)	0.047	1.049 (1.006, 1.092)	0.023	0.058	1.06 (1.007, 1.007)	0.025
Plasma concentration (ng/ml)	0.001	1.001 (1, 1.002)	0.015	0.001	1.001 (1.000, 1.003)	0.037
Baseline Hb (g/L)	−0.058	0.944 (0.911, 0.978)	0.001	−0.061	0.941 (0.904, 0.904)	0.003
Ferritin (ng/ml)	0.003	1.003 (0.999, 1.008)	0.111
Cause of kidney disease (%)	0.12	1.127 (0.806, 1.577)	0.484
Dosage of roxadustat (mg)	0.005	1.005 (0.999, 1.011)	0.121

Data availability statement

The datasets used and analyzed during the study are available from the corresponding author upon reasonable request.