Abstract

BackgroundThe present study aimed to clarify the efficacy and safety of hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) therapy for anemia in renal transplant (RTx) patients. MethodsAfter successful RTx, 26 patients requiring treatment for anemia were divided into 2 groups (erythropoiesis-stimulating agent [ESA] group and non-ESA group) based on whether an ESA was used before starting HIF-PHI therapy. The chronological changes in hemoglobin (Hb) values during the 6 months after the start of HIF-PHI therapy were investigated in each group, and the incidence of adverse events was compared. ResultsThere were 18 patients in the ESA group and 8 patients in the non-ESA group. The median (IQR) Hb values in the 2 groups were 11.35 (10.4–12.3) and 10.15 (8.9–10.4) g/dL, respectively. The chronological changes in the median (IQR) Hb values pre-HIF-PHI and 1, 3, and 6 months after starting HIF-PHI were 11.4 (10.4–12.4), 12.0 (10.7–12.4), 11.9 (10.9–13.4), and 11.5 (10.6–12.7) g/dL, respectively, in the ESA group, and 10.2 (8.7–10.4), 11.0 (10.4–11.7), 12.2 (11.6–13.2), and 12.5 (11.3–12.7) g/dL, respectively, in the non-ESA group. In the ESA group, Hb values were not significantly decreased after HIF-PHI administration (P = .14); in the non-ESA group, Hb values improved significantly (P = .002). Two patients developed diarrhea in the ESA group, and one patient developed appetite loss in the non-ESA group. ConclusionsHypoxia-inducible factor prolyl hydroxylase inhibitor was effective and safe for RTx patients regardless of prior ESA use.

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