High anaemia burden
Stage 5 CKD has a high prevalence of moderate to severe anaemia.
Dialysis-dependent CKD
OXEMIA® in dialysis-dependent CKD
Evidence and dosing information for adults receiving dialysis.
This page is intended for healthcare professionals.
Rx
Indicated for the treatment of anaemia in adult patients with chronic kidney disease on dialysis.
1
Why dialysis changes the anaemia picture
1
2
Loss
Blood loss
Blood can be lost from the circuit and sampling.
3
Inf
Inflammation and infection
Chronic inflammation can increase hepcidin.
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Iron restriction
Iron may be present but less available for production.
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Reduced EPO
Kidneys produce less erythropoietin.
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DREAM-D study design
Patients
392Centres across India
38RCT
Design
Randomised, open-label, active-controlled
Duration
24 weeksStudy target
10–12g/dL3
DREAM-D results
Least-square mean Hb change
0.95 g/dLDesidustat vs 0.80 g/dL epoetin alfaDifference 0.14 g/dL; 95% CI −0.1304 to 0.4202. Prespecified non-inferiority was met.
Haemoglobin responders
59.22%106/179 desidustat48.37% (89/184) with epoetin alfa; p=0.0382.
Trial safety
The study reported a comparable safety profile, with no new or increased risks observed versus epoetin in the trial.
Read DREAM-Di
Results are from the DREAM-D Phase III study. Individual results may vary.
4
Starting-dose pathway
1
New
New to ESA therapy
Start desidustat 100 mg three times weekly.
2
ESA
Converting from ESA
Select the starting dose using the PI conversion table.
3
Choose starting dose
100 mg, 125 mg or 150 mg three times weekly.
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Administration
Give after completion of the dialysis session.
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Monitoring
Reassess haemoglobin every four weeks and adjust.
i
The PI—not a trial publication—is the authority for conversion and administration.
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Dosing calendar examples
M/W/
Option 1
Mon · Wed · FriDoses two days apart.
T/T/
Option 2
Tue · Thu · SatDoses two days apart.
i
No food one hour before and two hours after. For dialysis, take after completion of the session.
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Guideline context
South Asia HIF-PHI Guideline
Desidustat might be offered as an alternative to ESAs for dialysis-dependent patients who do not prefer ESAs.
- Ensure iron repletion
- Very low certainty of evidence
- Explain potential benefits and harms
Ops
Dialysis-team operational focus
- Ongoing Hb and iron monitoring
- Vascular access management
- Dialysis adequacy
- Nutrition and overall care
7
Related evidence and resources
Real-world dialysis subgroup
Routine-practice evidence including dialysis recipients.
See routine-practice data12
PRCA
9
Safety and next steps
D