Abstract: FR-PO0208
Peridialytic Erythropoietin vs. Roxadustat in Hemodialysis-Dependent Patients with CKD
Session Information
- Anemia and Iron Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Wang, Li Hua, Department of Kidney Disease and Blood Purification Centre, 2nd Hospital of Tianjin Medical University, Tianjin, China
- Yuan, Weijie, Division of Nephrology, Department of Medicine, Shanghai First People Hospital, Jiao Tong University School of Medicine, Shanghai, China
- Yao, Li, Department of Nephrology, The First Hospital of China Medical University, Shenyang, China
- Yu, Pei, Department of Kidney Disease and Blood Purification Centre, 2nd Hospital of Tianjin Medical University, Tianjin, China
- Mei, Changlin, Division of Nephrology, Kidney Institute of PLA, Changzheng Hospital, Naval Medical University, Shanghai, China
Background
Erythropoietin and roxadustat are commonly used to manage anemia in hemodialysis-dependent chronic kidney disease (CKD) patients, but the comparative safety and effectiveness are unknown
Methods
Patients with CKD stage G5 and anemia (hemoglobin <100 g/L) who were treated with either erythropoietin or roxadustat were included. The primary endpoints included expanded composite of major adverse cardiovascular events (MACE+), in the peridialytic period, defined as the duration from the time of estimated glomerular filtration rate (eGFR) decrease to <15 mL/min to 3 months after dialysis initiation. A propensity score-matched analysis (1:1 ratio; caliper width: 0.02) was conducted to minimize the impact of confounding factors.
Results
1092 were included in the propensity score-matched analysis (546 in each group). In comparison to the roxadustat group, the erythropoietin group had a lower rate of MACE+ events within 6 months (13.4% vs. 21.2%; P<0.001) and 12 months of treatment initiation (17.0% vs. 24.0%; P=0.004), as well as within 3 months of hemodialysis initiation (12.9% vs. 28.7%; P<0.001). The rate of cardiocerebrovascular events was also lower in the erythropoietin group within 6 months (38.5% vs. 50.7%, P<0.001) and 12 months of treatment initiation (49.1% vs. 56.2%, P<0.001).
Conclusion
Peridialytic erythropoietin was associated with a more favorable cardiovascular safety profile versus roxadustat in hemodialysis-dependent CKD patients.
Proportions of patients with hospitalization for complications and length of hospital stay
| Characteristic | Erythropoietin | Roxadustat | P# |
| Within 6 months of treatment initiation, n (%) | 310 (56.8) | 383 (70.1) | <0.001 |
| Length of hospital stay, days* | 23.8±21.6 (10.0, 31.0) | 24.5±23.2 (12.0, 29.0) | 0.471 |
| Within 12 months of treatment initiation, n (%) | 358 (65.6) | 412 (75.5) | <0.001 |
| Length of hospital stay, days* | 27.5±26.4 (11.0, 35.0) | 28.3±29.1 (13.0, 34.0) | 0.372 |
| Within 3 months of hemodialysis initiation, n(%) | 284 (52.0) | 326 (59.7) | 0.010 |
| Length of hospital stay, days* | 20.1±13.9 (11.0, 27.0) | 23.2±15.5 (12.5, 30.0) | 0.014 |