{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T21:56:14Z","timestamp":1789250174860,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The efficacy of oral roxadustat in dialysis patients with renal anemia and overt infections remains uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In this retrospective cohort study, 2816 such patients were screened, of whom 167 were enrolled and assigned to either roxadustat (n = 88) or recombinant human EPO (rHuEPO; n = 79) for treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Baseline hemoglobin levels were 90.3 \u00b1 15.2 g\/L and 91.9 \u00b1 17.8 g\/L, respectively. All patients received a mean of 10.6 \u00b1 3.3 days of infection treatment. Types of infection included pulmonary, peritoneal dialysis-associated peritonitis, catheterrelated, urinary tract, and others. Compared with rHuEPO, roxadustat led to significantly greater increases in hemoglobin and \u0394Hb, and more pronounced improvements in ferritin, transferrin saturation (TSAT), and hepcidin levels following infection. The analysis demonstrated that TSAT, hepcidin, dialysis modality, residual renal function, infection type, and PCT levels play critical roles in mediating the efficacy of roxadustat under active infection conditions. Among peritoneal dialysis patients, roxadustat was associated with significantly greater improvements in \u0394Hb, ferritin, and TSAT compared to rHuEPO. \u0394Hb values varied by infection type, with significantly higher increases in peritoneal dialysis-associated peritonitis and a trend toward larger \u0394Hb in other infections relative to those in pulmonary infections. Based on procalcitonin levels, more severe infections were correlated with lower \u0394Hb values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overal, roxadustat was more effective than rHuEPO in ameliorating renal anemia in infected dialysis patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1695376","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:43:00Z","timestamp":1759902180000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of roxadustat on anemia management in infected patients undergoing long-term dialysis: a retrospective cohort analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Lulu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinqi","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunming","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1681\/ASN.2019060623","article-title":"Phase 3, randomized, double-blind, active-comparator (darbepoetin alfa) study of oral roxadustat in CKD patients with anemia on hemodialysis in Japan","volume":"31","author":"Akizawa","year":"2020","journal-title":"J. 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