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Kidney Week

Abstract: TH-PO957

Red Blood Cell Distribution Width-Coefficient of Variation as an Indicator of the Requirement for and Efficacy of Daprodustat in Hemodialysis Patients Switching from Erythropoietin-Stimulating Agents

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
Background

Red blood cell distribution width (RDW) is an index of red blood cell volume variability and is used as a marker of iron deficiency anemia. In both hemodialysis and chronic kidney disease patients, a high RDW is associated with a higher mortality risk. Indicators of the requirement for and efficacy of daprodustat have not been reported previously. Therefore, we investigated whether the RDW-coefficient of variation (CV) is an indicator of the requirement for and efficacy of daprodustat when switching from erythropoietin-stimulating agents (ESAs) to daprodustat in patients undergoing maintenance hemodialysis.

Methods

This historical cohort study included 37 patients undergoing maintenance hemodialysis and who switched from ESAs to daprodustat at our affiliated institutions. The patients were divided into two groups by an RDW-CV cut-off of 14.2%. Propensity score matching was performed by sex, diabetes mellitus, iron sufficiency, albumin concentration, and C-reactive protein concentration. We examined whether there was a difference in the requirement for daprodustat and in the hypoxia-inducible factor prolyl hydroxylase inhibitor resistance index (HRI; defined as daprodustat dose / dry weight / hemoglobin) after 6 months between the two groups.

Results

In the two groups of patients matched for background factors by propensity scores (10 patients with an RDW-CV of ≤14.2%, 10 patients with an RDW-CV of >14.2%), significant differences were observed in both the requirement for daprodustat (4.4 mg at an RDW-CV of ≤14.2%, 8.0 mg at an RDW-CV of >14.2%; P < 0.05) and HRI (0.0068 at an RDW-CV of ≤14.2%, 0.0120 at an RDW-CV of >14.2%; P < 0.05) after 6 months.

Conclusion

RDW-CV is an indicator of the requirement for and efficacy of daprodustat in hemodialysis patients switching from ESAs.