{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:37:52Z","timestamp":1784079472939,"version":"3.55.0"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Anemia management in maintenance hemodialysis patients with erythropoiesis-stimulating agent (ESA) hyporesponsiveness remains challenging. Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, offers a mechanistically distinct alternative. Materials and Methods: This multicenter retrospective study analyzed 110 hemodialysis patients with persistent anemia (Hemoglobin (Hb) &lt; 10 g\/dL) despite \u2265 3 months of maximum-reimbursable-dose ESA therapy in T\u00fcrkiye. Outcomes were evaluated between patients who switched to Roxadustat (n = 80) and those who continued ESA therapy (n = 30) over 6 months in a non-randomized, observational comparison. Results: At baseline, median Hb levels were significantly lower in the Roxadustat-group than in the ESA-group (8.70 vs. 9.50 g\/dL; p &lt; 0.001), while weight-adjusted ESA doses were comparable (p = 0.332). By Month 6, the Roxadustat group achieved a significant Hb increase (from 8.70 to 9.95 g\/dL), whereas the ESA-group showed no significant change (9.50 to 9.65 g\/dL), and end-of-treatment Hb did not differ significantly between groups. The unadjusted mean Hb rise was greater in the Roxadustat cohort than in the ESA cohort (+1.40 \u00b1 1.55 vs. +0.65 \u00b1 1.93 g\/dL; p = 0.037). However, after adjustment for baseline Hb (ANCOVA), baseline Hb predicted final Hb, while treatment group was not independently associated with final Hb. Transfusion requirements declined over follow-up in both groups. No new short-term safety signal was identified based on available clinical documentation. Conclusions: Roxadustat improved Hb in ESA-hyporesponsive patients with lower baseline Hb, but adjusted analyses indicated that baseline severity influenced response. Targets were not consistently achieved; these findings are hypothesis-generating regarding dose optimization, treatment duration, and earlier initiation.<\/jats:p>","DOI":"10.3390\/medicina62030460","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T16:06:59Z","timestamp":1772467619000},"page":"460","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Roxadustat for Erythropoiesis-Stimulating Agent Hyporesponsive Anemia in Hemodialysis: Multicenter Retrospective Analysis"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-8068","authenticated-orcid":false,"given":"Ilyas","family":"Ozturk","sequence":"first","affiliation":[{"name":"Department of Nephrology, Kahramanmaras Necip Fazil City Hospital, 46050 Kahramanmaras, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meliha","family":"Ozkutlu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Mehmet Akif Inan Education and Research Hospital, 63040 Sanliurfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Aktar","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kahramanmaras Necip Fazil City Hospital, 46050 Kahramanmaras, T\u00fcrkiye"},{"name":"Department of Nephrology, Istanbul Aydin University, Medical Park Florya Hospital, 34295 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7903-1106","authenticated-orcid":false,"given":"Cihan","family":"Heybeli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Mus State Hospital, 49100 Mus, T\u00fcrkiye"},{"name":"Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Huzmeli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hatay Education and Research Hospital, 31027 Hatay, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Sanliurfa Education and Research Hospital, 63250 Sanliurfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda Safak","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Gaziantep City Hospital, 27470 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2863-7882","authenticated-orcid":false,"given":"Tulin","family":"Akagun","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Giresun University, 28200 Giresun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0881-7851","authenticated-orcid":false,"given":"Ekrem","family":"Kara","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, 53100 Rize, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-9002","authenticated-orcid":false,"given":"Neriman Sila","family":"Koc","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Harran University, 63300 Sanliurfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Tuncay","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Gaziantep City Hospital, 27470 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-4421","authenticated-orcid":false,"given":"Tuncay","family":"Sahutoglu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Health Sciences, Mehmet Akif Inan Education and Research Hospital, 63040 Sanliurfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"ref_1","unstructured":"Eknoyan, G., Lameire, N., Winkelmayer, W.C., Jadoul, M., Jadoul, G.E., Ashuntantang, G.E., O\u2019Shaughnessy, M.M., Noronha, I.d.L., Rossignol, P., and Denburg, M.R. 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