{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T00:17:13Z","timestamp":1793924233067,"version":"4.8.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":61,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are a novel therapeutic alternative to erythropoiesis-stimulating agents (ESAs) for anemia in chronic kidney disease. Evidence regarding their real-world effectiveness is still limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS, 2019\u20132022) to assess the real-world effectiveness of HIF-PHIs among maintenance hemodialysis patients. We compared patients who transitioned from ESAs to HIF-PHIs with those who continued ESAs, focusing on baseline characteristics and changes in anemia-related, iron metabolism, and inflammatory parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1433 patients on ESAs, only 56 (3.9%) were switched to HIF-PHIs. Compared with the ESA continuation group, patients in the HIF-PHI group had poorer nutritional status (albumin: 3.3 vs. 3.6\u2009g\/dL; cholesterol: 142 vs. 156\u2009mg\/dL; respectively) and greater ESA resistance (erythropoietin resistance index: 18.4 vs. 8.5 IU\/kg\/week\/g\/dL, respectively), despite higher ESA doses and iron prescription rates. After switching, a significant increase in hemoglobin was observed at 1\u2009month (+0.44\u2009g\/dL; 95% confidence interval: 0.05\u20130.82;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025). Serum iron and total iron-binding capacity levels also increased, while transferrin saturation and ferritin remained unchanged. A subgroup analysis suggested greater hemoglobin response in patients with high C-reactive protein levels (p for interaction\u2009=\u20090.074), but no difference by erythropoietin resistance index (p for interaction\u2009=\u20090.372).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In routine clinical practice, HIF-PHIs were selectively prescribed to patients with treatment-refractory anemia. Treatment increased hemoglobin levels, with a suggestive trend toward greater effect among those with inflammation, supporting the potential utility of HIF-PHIs in complex anemia management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-026-04831-2","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:36:05Z","timestamp":1771490165000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-world use of HIF-PH inhibitors in the Japan dialysis outcomes and practice patterns study (J-DOPPS, 2019\u20132022)"],"prefix":"10.1186","volume":"27","author":[{"given":"Masahiro","family":"Eriguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Tsuruya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Noma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Onishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Inuzuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"20","key":"4831_CR1","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1056\/nejmoa062276","volume":"355","author":"TB Dr\u00fceke","year":"2006","unstructured":"Dr\u00fceke TB, Locatelli F, Clyne N, Eckardt K-U, Macdougall IC, Tsakiris D, et al. 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All procedures were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments. In the primary J-DOPPS study, informed consent was obtained from all participants for the use of their data in J-DOPPS-related research. The database is fully de-identified and contains no personally identifiable information. Therefore, no additional consent procedures were required for the present study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"ME receives a writing honorarium from Kyowa Kirin related to the preparation of this manuscript. MN receives lecture fees from Kyowa Kirin, Bayer, Mitsubishi Tanabe and research grants from Kyowa Kirin, Chugai, Mitsubishi Tanabe, Torii, JT, BI. MI and KH are employees of Kyowa Kirin and own stock in the company. The remaining authors have declared that no conflict of interest exists.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"250"}}