Thyroid function analysis after roxadustat or erythropoietin treatment in patients with renal anemia: a cohort study

Figures & data

Figure 1. Flow chart.

Table 1. Comparison of baseline characteristics in subjects with rHuEPO and roxadustat treatment in patients with renal anemia.

Characteristics	rHuEPO	Roxadustat	Effect value	p-Value
Age, year	72 (58.5,80.75)	65.5 (56.75,74)	−1.57	0.117
Male, n%	21 (35.0)	25 (50.0)	−1.58	0.114
Dialysis mode			−0.61	0.545
Nondialysis, n%	28 (46.66)	21 (42.0)
Peritoneal dialysis, n%	16 (26.67)	13 (26.0)
Hemodialysis, n%	16 (27.67)	16 (32.0)
Thyroid nodule			−0.45	0.653
No, n%	50 (83.33)	40 (80.0)
Yes, n%	10 (16.67)	10 (20.0)
Causes of kidney disease			−0.69	0.491
Nonimmune, n%	50 (83.33)	44 (88.0)
Immune, n %	10 (16.67)	6 (12.0)
TSH, 0.56–5.91μIU/ml	2.18 (1.56,3.83)	2.21 (1.55,3.44)	−0.048	0.962
TT3, 1.01–2.48 nmol/l	1.01 ± 0.39	1.13 ± 0.36	−1.58	0.118
TT4, 69.97–152.52 nmol/l	122.16 ± 32.15	118.42 ± 23.85	0.70	0.486
FT3, 3.28–6.47 pmol/l	4.09 ± 0.62	4.12 ± 0.84	−0.17	0.870
FT4, 7.64–16.03 pmol/l	11.86 ± 2.50	11.01 ± 2.29	1.86	0.065

TSH: thyroid stimulating hormone; TT3: total triiodothyronine; TT4: total thyroxin; FT3: free triiodothyronine; FT4: free thyroxin.

Table 2. Comparison of serum TSH, TT3, TT4, FT3 and FT4 between the rHuEPO and roxadustat groups.

	Reference range	rHuEPO	Roxadustat	Effect value	p-Value
TSH, μIU/ml	0.56–5.91	2.01 (1.13,3.78)	1.14 (0.40,2.15)	−3.32	0.001
TT3, nmol/l	1.01–2.48	0.91 ± 0.34	0.80 ± 0.32	1.76	0.081
TT4, nmol/l	69.97–152.52	111.69 ± 30.75	90.03 ± 27.69	3.85	<0.001
FT3, pmol/l	3.28–6.47	3.77 ± 0.75	3.42 ± 0.67	2.56	0.012
FT4, pmol/l	7.64–16.03	11.27 ± 2.83	9.84 ± 3.16	2.51	0.014

TSH: thyroid stimulating hormone; TT3: total triiodothyronine; TT4: total thyroxin; FT3: free triiodothyronine; FT4: free thyroxin.

Figure 2. Cumulative incidence curves for thyroid dysfunction for roxadustat vs. rHuEPO.

Table 3. Association between roxadustat and the occurrence of thyroid dysfunction.

	Unadjusted	Model 1			Model 2
	HR (95%Cl)	p Value	HR (95%Cl)	p Value	HR (95%Cl)	p Value
rHuEPO	Reference		Reference		Reference
Roxadustat	3.19(1.86,5.46)	<0.001	3.30(1.90,5.73)	<0.001	3.37(1.94,5.87)	<0.001

Model 1 was adjusted for age and sex; Model 2 was adjusted for age, sex, dialysis mode, thyroid nodule, and causes of kidney disease.

95%CI: 95% confidence interval; HR: hazard ratio.

Table 4. Interaction between the treatments of renal anemia and basic information on the incidence of thyroid dysfunction.

Characteristic	HR (95%Cl)	p Value	P for interaction
Age			0.407
<65	3.53 (1.22,10.25)	0.020
65-	4.30 (2.14,8.64)	<0.001
Sex			0.091
Male	3.87 (1.66,9.02)	0.002
Female	3.49 (1.62,7.51)	0.001
Dialysis mode			0.298
Nondialysis	2.61 (1.22,5.58)	0.014
Peritoneal dialysis	3.53 (0.84,14.84)	0.085
Hemodialysis	6.81 (2.27,20.49)	0.001
Thyroid nodule			0.922
No	3.16 (1.72,5.79)	<0.001
Yes	10.10 (1.34,75.86)	0.025
Causes of kidney disease			0.805
Nonimmune	3.09 (1.70,5.60)	<0.001
Immune	5.92 (0.83,42.20)	0.076

The model was adjusted for age, sex, dialysis mode, thyroid nodule, and causes of kidney disease.

95%CI: 95% confidence interval; HR: hazard ratio.