Kidney Week

Abstract: PUB040

Treatment of an Anemic Patient with CKD with Oral Vadadustat

Session Information

• Publication Only

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Patel, Sunil H., Advanced Medical and Kidney Institute, Apple Valley, California, United States

Sunil H. Patel, DO

• Qazi, Yasir A., University of Southern California, Los Angeles, California, United States

Yasir A. Qazi, MD

• Patel, Sohan, Advanced Medical and Kidney Institute, Apple Valley, California, United States

Sohan Patel

Introduction

Chronic Kidney Disease (CKD) has multiple complications, including Anemia, treatment of which has been lmited to replacement of iron and sythetic erythropoietin, or transfusion. Discovery of the Hypoxia Inducible Factor (HIF) Pathway has lead to the development of a new oral class of medicines for the management of anemia in patient's with CKD on dialysis. HIF Pathway enzyme inhibitor, such as vadadustat, has been available in Asia for several years, and holds promise in stimulating endogenous erythropoietin; therefore, improving hemoglobin concentrations to the guideline recommended levels of 10-11 g/dl. Recently FDA approved vadadustat in the United States of America (USA) providing additional treatment options for dialysis patients.

Case Description

A 34 year-old hispanic-caucasian female with end stage renal disease (ESRD) due to Lupus Nephritis was treated with HIF Pathway enzyme inhibitor, vadadudstat. Patient's extra-renal systemic lupus has stablized with use of hydroxychloroquine and low dose mycophenolate. Patient previously was on peritoneal dialysis, during which time her hemoglobin met goals of 10-11 g/dl as per KDIGO guidelines; however, she required high dose of synthetic erythropoietin: approximately 15,000 units per week. In January of 2024, she was transitioned to home-hemodialysis-modality due to recurrent peritonitis. Patient has received sythetic erythropoietin averaging 15,000 units per week. Prior to vadadustat start, her hemoglobin averaged 9.7 g/dl. In January of 2025 she was swithced from epogen to vadadustat 300 mg oral daily. Her subsequent hemoglobin levels showed improvement: 10.6 mg/dl.

Discussion

Vadadustat (Vafseo) has been available since January 2025 in USA. It is a HIF Pathway enzyme inhibitor and works through physiological transcription and thus may require an extended period to have effect. This case demonstrates that some patients may respond quicker, reducing requirement of frequent high dose of synthetic erythropoietin.

Anemia Management Report

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20254qqzskh0