Comparison of Roxadustat with Erythropoietin in Terms of Efficacy in Anemia of ChronicKidney Disease (CKD) Stage IV and V

Objective: To compare efficacy of Roxadustat with Erythropoietin in anemia of chronic kidney disease stage four and five patients. Study Design: Randomized controlled trial studyPlace and Duration of Study: This study was conducted at the Department of Nephrology, KRL Hospital Islamabad from 10 November 2025 to 10 May 2026. Methods: Total 150 patients were included and divided into two groups, Roxadustat group n=75 and Erythropoietin group n=75. Patients aged 18–70 years with anemia of chronic kidney disease stage four and five were selected. Patients were followed for 12 weeks and haemoglobin levels were measured at 4, 6 and 12 weeks. Requirement of blood transfusion was also recorded. Independent sample t-test was applied for comparison of mean haemoglobin, while chi-square and fisher exact test were used for categorical variables. Results: Mean age was 53.60 ± 12.05 years in Roxadustat group and 50.55 ± 11.41 years in erythropoietin group. Males were 48 (64.0%) and 43 (57.3%) respectively. At baseline haemoglobin was comparable (8.67 ± 0.77 vs 8.44± 0.82 g/dL, p=0.077). At 4, 6 and 12 weeks haemoglobin was significantly higher in Roxadustat group (9.41 ± 0.79 vs 9.05 ± 0.83, p=0.008; 10.02 ± 0.90 vs 9.57 ± 0.92, p=0.003; 11.06 ± 0.74 vs 10.37 ± 0.83, p<0.001). Bloodtransfusion was less in Roxadustat group at 4 weeks 7 (9.3%) vs 24 (32.0%), and at 6 weeks 3 (4.0%) vs 19 (25.3%) (p<0.001). Conclusion: Roxadustat showed better haemoglobin improvement and less transfusion need as compared to erythropoietin in these patients.