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A 65-year-old female with chronic kidney disease (CKD) stage 5 on peritoneal dialysis presented with Erythropoiesis-stimulating agent (ESA)-hyporesponsive anemia, which may be associated with impaired iron utilization, occult infection, or a state of chronic inflammation. Despite high doses of rHuEPO, her hemoglobin levels remained low. Switching to Hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHI) at a dosage of 120 mg three times weekly led to a significant increase in hemoglobin and improved iron utilization. ESA hyporesponsiveness is common in dialyzed patients with the long-term use of ESA therapy, which may be related to CKD-related inflammatory response and oxidative stress. This case highlights the effectiveness of HIF-PHI in treating patients with ESA-hyporesponsive anemia, underscoring its importance in managing renal anemia.

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Treatment of a Patient with Peritoneal Dialysis Combined with Erythropoietin-Hyporesponsive Anemia

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  • 出版模式：

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  • 发表日期：

    2025年

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  • Hong Chu,
  • Jie Dong

摘要

A 65-year-old female with chronic kidney disease (CKD) stage 5 on peritoneal dialysis presented with Erythropoiesis-stimulating agent (ESA)-hyporesponsive anemia, which may be associated with impaired iron utilization, occult infection, or a state of chronic inflammation. Despite high doses of rHuEPO, her hemoglobin levels remained low. Switching to Hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHI) at a dosage of 120 mg three times weekly led to a significant increase in hemoglobin and improved iron utilization. ESA hyporesponsiveness is common in dialyzed patients with the long-term use of ESA therapy, which may be related to CKD-related inflammatory response and oxidative stress. This case highlights the effectiveness of HIF-PHI in treating patients with ESA-hyporesponsive anemia, underscoring its importance in managing renal anemia.