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目的:观察罗沙司他治疗重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)治疗效果不佳的钙化防御透析患者肾性贫血的疗效和安全性。方法:本研究为前瞻性队列研究,筛选2019年1月1日至2021年3月28日期间于东南大学附属中大医院肾内科确诊钙化防御且既往规律使用rHuEPO≥3个月血红蛋白(hemoglobin,Hb)仍未达标(Hb<110 g/L)的透析患者。采用自身前后对照,分析口服罗沙司他对钙化防御透析患者肾性贫血的疗效。结果:本研究共纳入钙化防御合并肾性贫血透析患者18例,年龄(49.7±16.2)岁,其中男性11例,女性7例,血液透析14例,腹膜透析4例。入组时所有患者超敏C反应蛋白(参考值0~3 mg/L)为27.3(15.6,48.5)mg/L。基线Hb为(85.4±11.6)g/L,口服罗沙司他3个月时Hb为(105.8±15.2)g/L,较前显著升高,差异有统计学意义(n t=-9.282,n P<0.001)。Hb达标率为44.4%(8/18)。使用罗沙司他治疗3个月铁蛋白水平较基线值下降[208.0(59.0,306.3)μg/L比229.0(127.3,385.2)μg/L,n Z=-3.637,n P<0.001],总铁结合力水平较基线值上升[127.0(65.0,211.5)μmol/L比105.5(43.8,153.7)μmol/L,n Z=-2.156,n P=0.031],转铁蛋白饱和度水平较基线水平轻度下降[20.2%(14.2%,27.7%)比20.5%(18.7%,34.9%),n Z=-1.546,n P=0.122],但差异无统计学意义。所有患者用药期间无不良反应发生。n 结论:罗沙司他能有效纠正炎症状态下钙化防御合并肾性贫血透析患者的Hb水平,改善铁代谢,安全性高。“,”Objective:To observe the efficacy and safety of roxadustat in the treatment of renal anemia in calciphylaxis dialysis patients who had poor response to recombinant human erythropoietin (rHuEPO).Methods:This study was a prospective cohort study. The dialysis patients who were diagnosed with calciphylaxis and had previous regular use of rHuEPO≥3 months with hemoglobin (Hb) levels<110 g/L in the Department of Nephrology of Zhong Da Hospital affiliated to Southeast University from January 1, 2019 to March 28, 2021 were recruited. The effect of oral roxadustat in calciphylaxis dialysis patients with renal anemia was analyzed by self-comparison method.Results:There were totally 18 calciphylaxis dialysis patients with renal anemia enrolled in the study and the age was (49.7±16.2) years old, including 11 males and 7 females, and 14 cases on hemodialysis and 4 cases on peritoneal dialysis. The high-sensitivity C-reactive protein level was 27.3(15.6, 48.5) mg/L(reference value 0-3 mg/L) at baseline. The baseline Hb level was (85.4±11.6) g/L, and after 3 months of oral roxadustat, the Hb level was (105.8±15.2) g/L (n t=-9.282, n P<0.001). The Hb compliance rate was 44.4%(8/18). Ferritin decreased significantly at 3 months compared with the baseline level [208.0(59.0, 306.3) μg/L vs 229.0(127.3, 385.2) μg/L,n Z=-3.637, n P<0.001]. The total iron binding capacity level increased significantly compared with the baseline level [127.0(65.0, 211.5) μmol/L vs 105.5(43.8, 153.7) μmol/L,n Z=-2.156, n P=0.031]. Transferrin saturation level at 3 months was lower than that at baseline, but there was no significant difference [20.2%(14.2%, 27.7%) vs 20.5%(18.7%, 34.9%), n Z=-1.546, n P=0.122]. No adverse reactions occurred during the observation period.n Conclusion:The application of roxadustat can effectively correct Hb level and improve iron metabolism with high safety in calciphylaxis dialysis patients with renal anemia under inflammatory status.