What side effects should dialysis patients be wary of when taking daprostat?

Daprodustat (Daprodustat), as a new oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), shows good promise in the treatment of anemia in dialysis patients with chronic kidney disease. However, dialysis patients need to be particularly vigilant about potential side effects while taking daprostat. According to overseas clinical trial data, common adverse reactions include hypertension, peripheral edema, thrombotic events, nausea, diarrhea and headache. Because daprostat promotes the production of endogenous erythropoietin (EPO) by regulating the body's response mechanism to hypoxia, although this effect helps improve anemia, it may also stimulate an increase in blood viscosity, leading to an increased risk of thrombosis, which is especially important for dialysis patients with a history of atherosclerosis or cardiovascular disease.

In addition, some studies have pointed out that daprostat may cause an increase in blood potassium levels, that is, hyperkalemia, which requires great attention in dialysis patients because electrolyte imbalance itself is a high-risk problem in the dialysis population. Patients with uncontrolled hypertension, active bleeding, cancer risk, or severe hepatic insufficiency should undergo a detailed evaluation before use of daprixostat. It has also been observed in clinical practice that a small number of patients experience worsening of heart failure or increased risk of infection. Although the incidence is low, regular monitoring of blood pressure, hemoglobin levels, electrolyte status and cardiac function during treatment is still necessary.

Currently, when international guidelines recommend daporostat, they usually emphasize maintaining treatment goals at the lowest effective dose to avoid excessive rise in hemoglobin levels, because rapid correction of anemia may further increase the probability of cardiovascular and cerebrovascular events. It should be noted that daprostat is different from traditional intravenous erythropoietin preparations (ESA). Although the oral route is convenient, it also requires patients to have good medication compliance and regular follow-up.

Reference materials:https://en.wikipedia.org/wiki/Daprodustat