Watanabe, K.* ; Sato, E.* ; Mishima, E. ; Moriya, S.* ; Sakabe, T.* ; Sato, A.* ; Fujiwara, M.* ; Fujimaru, T.* ; Ito, Y.* ; Taki, F.* ; Nagahama, M.* ; Tanaka, K.* ; Kazama, J.J.* ; Nakayama, M.*
     
    
        
Changes in metabolomic profiles induced by switching from an erythropoiesis-stimulating agent to a hypoxia-inducible factor prolyl hydroxylase inhibitor in hemodialysis patients: A pilot study.
    
    
        
    
    
        
        Int. J. Mol. Sci. 24:14 (2023)
    
    
    
      
      
	
	    Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are a new class of medications for managing renal anemia in patients with chronic kidney disease (CKD). In addition to their erythropoietic activity, HIF-PHIs exhibit multifaceted effects on iron and glucose metabolism, mitochondrial metabolism, and angiogenesis through the regulation of a wide range of HIF-responsive gene expressions. However, the systemic biological effects of HIF-PHIs in CKD patients have not been fully explored. In this prospective, single-center study, we comprehensively investigated changes in plasma metabolomic profiles following the switch from an erythropoiesis-stimulating agent (ESA) to an HIF-PHI, daprodustat, in 10 maintenance hemodialysis patients. Plasma metabolites were measured before and three months after the switch from an ESA to an HIF-PHI. Among 106 individual markers detected in plasma, significant changes were found in four compounds (erythrulose, n-butyrylglycine, threonine, and leucine), and notable but non-significant changes were found in another five compounds (inositol, phosphoric acid, lyxose, arabinose, and hydroxylamine). Pathway analysis indicated decreased levels of plasma metabolites, particularly those involved in phosphatidylinositol signaling, ascorbate and aldarate metabolism, and inositol phosphate metabolism. Our results provide detailed insights into the systemic biological effects of HIF-PHIs in hemodialysis patients and are expected to contribute to an evaluation of the potential side effects that may result from long-term use of this class of drugs.
	
	
	    
	
       
      
	
	    
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        Publication type
        Article: Journal article
    
 
    
        Document type
        Scientific Article
    
 
    
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        Keywords
        Clinical Trial ; Erythropoiesis-stimulating Agents ; Hemodialysis ; Hypoxia-inducible Factor Prolyl Hydroxylase Inhibitors ; Metabolomic Analysis ; Pleiotropic Effects; Chronic Kidney-disease; Insulin-resistance; Darbepoetin Alpha; Double-blind; Anemia; Phase-3; Myoinositol; Roxadustat; Vadadustat; Efficacy
    
 
    
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        Language
        english
    
 
    
        Publication Year
        2023
    
 
    
        Prepublished in Year
        0
    
 
    
        HGF-reported in Year
        2023
    
 
    
    
        ISSN (print) / ISBN
        1661-6596
    
 
    
        e-ISSN
        1422-0067
    
 
    
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	    Volume: 24,  
	    Issue: 16,  
	    Pages: ,  
	    Article Number: 14 
	    Supplement: ,  
	
    
 
    
        
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            MDPI
        
 
        
            Publishing Place
            Basel
        
 
	
        
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        Reviewing status
        Peer reviewed
    
 
     
    
        POF-Topic(s)
        30203 - Molecular Targets and Therapies
    
 
    
        Research field(s)
        Genetics and Epidemiology
    
 
    
        PSP Element(s)
        G-506900-001
    
 
    
        Grants
        
JSPS KAKENHI
This work was supported by JSPS KAKENHI Grant Number 22K11347.
    
 
    
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        Erfassungsdatum
        2023-10-06