2026-10-14T10:07:15Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34045521 2026-10-01T12:00:31Z category_4 category_7 category_16 category_873 category_64 portal_87 item_type_3 month_year_10_2026

Initial side effects of roxadustat on thyroid function in patients undergoing hemodialysis Hideyuki Yamada (149801) Rena Yuasa (25156407) Kiyoto Koibuchi (16904014) Moriatsu Miyagi (25156410) Ken Sakai (1747909) Biochemistry Medicine Physiology Chemical Sciences not elsewhere classified Cancer Roxadustat HIF-PH inhibitor central hypothyroidism hemodialysis <p>Roxadustat, a hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, is effective for treating renal anemia, with efficacy noninferior to erythropoiesis-stimulating agents. However, data on its adverse effects remain scarce. In medical practice, roxadustat administration reportedly leads to central hypothyroidism; however, the frequency of its occurrence remains unclear. We investigated thyroid function in patients undergoing dialysis who received roxadustat at Saiseikai Yokohamashi Tobu Hospital, with particular focus on the timing of the decrease in serum thyroid-stimulating hormone (TSH) levels after roxadustat initiation and the subsequent course of thyroid function. HIF-PH inhibitors were administered to 43 chronic kidney disease patients including dialysis. After 2 weeks of roxadustat administration, we extracted the data of 16 hemodialysis patients who exhibited absence of residual urine and were able to undergo blood tests. All patients revealed decreased serum TSH levels. In contrast, changes in serum free triiodothyronine and free thyroxine levels were minor. None of the patients reported fatigue, bradycardia, or constipation, which are common symptoms of hypothyroidism. Our findings revealed that roxadustat may cause TSH reduction after 2 weeks of administration, though some patients showed subclinical hypothyroidism with high TSH levels. In a few cases, TSH levels decreased to one-tenth of the normal values. Despite these rapid changes, none of the patients exhibited clinical symptoms. Hence, regular thyroid hormone level monitoring is necessary with roxadustat administration, regardless of patients’ history of thyroid function.</p> <p>Roxadustat is a relatively new medication used to treat anemia in patients with chronic kidney disease. While it is known to be as effective as conventional treatments, its side effects are not yet fully understood.</p> <p>In this study, we examined how roxadustat affects thyroid function in patients undergoing hemodialysis. We found that levels of thyroid-stimulating hormone (TSH), which regulates thyroid function, decreased in all patients within 2 weeks after starting roxadustat. However, other free thyroid hormone levels showed only small changes, and none of the patients developed symptoms of hypothyroidism such as fatigue or constipation.</p> <p>These results suggest that roxadustat can alter thyroid-related laboratory values without causing noticeable symptoms. Therefore, thyroid function should be monitored regularly from the early phase of roxadustat treatment, even in patients without a history of thyroid disease.</p> <p>What is known</p> <p>Roxadustat is an effective treatment for renal anemia, but its effects on thyroid function are not well established.</p> <p>What this study adds</p> <p>Roxadustat may cause an early reduction in TSH levels within 2 weeks of initiation in patients undergoing hemodialysis, without significant changes in free thyroid hormone level or clinical symptoms.</p> <p>Potential impact</p> <p>Routine monitoring of thyroid function should be considered from the early phase of roxadustat treatment, even in patients without a history of thyroid disease.</p> 2026-10-01T12:00:31Z Dataset Dataset 10.6084/m9.figshare.34045521.v1 https://figshare.com/articles/dataset/Initial_side_effects_of_roxadustat_on_thyroid_function_in_patients_undergoing_hemodialysis/34045521 CC BY 4.0