{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:15:09Z","timestamp":1790252109738,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Anemia is the most common complication of end\u2010stage renal disease (ESRD). While erythropoiesis\u2010stimulating agents (ESA) have improved treatment outcomes, some patients exhibit intolerance or hyporesponsiveness. Roxadustat, a hypoxia\u2010inducible factor prolyl hydroxylase inhibitor (HIF\u2010PHI), improves erythropoiesis and iron metabolism, offering advantages in ESA\u2010refractory cases. However, its use in pediatric populations remains limited. We present a case of a 13\u2010year\u2010old girl on maintenance hemodialysis who exhibited both hyporesponsiveness and intolerance to ESA. Initiation of oral Roxadustat resulted in a sustained improvement in hemoglobin levels, accompanied by notable enhancements in iron metabolism and clinical symptoms. So far, over 5\u2009years of follow\u2010up, no significant adverse events were observed. Oral Roxadustat appears to be an effective and safe treatment option for teenage hemodialysis patients who are resistant or intolerant to ESA.<\/jats:p>","DOI":"10.1002\/ccr3.70985","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:42:36Z","timestamp":1758948156000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Roxadustat for\n                    <scp>ESA<\/scp>\n                    \u2010Hyporesponsive Renal Anemia in a 13\u2010Year\u2010Old on Hemodialysis: Case Report and Mini\u2010Review"],"prefix":"10.1002","volume":"13","author":[{"given":"Meng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Nephrology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanchao","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Blood Purification Center, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2035-9259","authenticated-orcid":false,"given":"Juan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei 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