Evidence map›Paper›PMID 42185975›Full record

Observational studyBMC nephrology2026

Patient characteristics and treatment efficacy after switching to hypoxia-inducible factor-prolyl hydroxylase inhibitors from erythropoiesis-stimulating agents in non-dialysis-dependent chronic kidney disease patients: the Reach-J CKD cohort study.

Kunihiro Yamagata, Tomohiro Ohigashi, Chie Saito, Hirayasu Kai, Ryoya Tsunoda, Reiko Okubo, Masahide Kondo, Haruka Ishii, Masami Inuzuka, Kenji Harada and 5 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Kunihiro YamagataDepartment of Nephrology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. k-yamaga@md.tsukuba.ac.jp.
Tomohiro OhigashiDepartment of Biostatistics, University of Tsukuba, Tsukuba, Japan.
Chie SaitoDepartment of Nephrology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Hirayasu KaiDepartment of Nephrology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Ryoya TsunodaDepartment of Nephrology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Reiko OkuboDepartment of Nephrology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Masahide KondoDepartment of Health Economics, University of Tsukuba, Tsukuba, Japan.
Haruka IshiiMedical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan.
Masami InuzukaMedical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan.
Kenji HaradaMedical Affairs Department, Kyowa Kirin Co., Ltd., Tokyo, Japan.
Ichiei NaritaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Hirokazu OkadaDepartment of Nephrology, Saitama Medical University, Moroyama, Japan.
Takashi WadaDepartment of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan.
Shoichi MaruyamaDepartment of Nephrology, Nagoya University, Nagoya, Japan.
Junichi HoshinoDepartment of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are likely to be effective in patients with anemia in chronic kidney disease (CKD) who are resistant to treatment with erythropoiesis-stimulating agents (ESAs). However, few studies assess HIF-PHIs in patients with elevated ERI who do not yet require hemodialysis.

methodsThis multicenter, prospective, observational study utilized data from the Reach-J study to explore the characteristics of Japanese patients with anemia in CKD (stage G3b-5) who switched from ESAs to HIF-PHIs. We also examined changes in hemoglobin levels following switching.

resultsWe assessed 447 patients who continued ESA treatment and 34 patients who switched from ESAs to HIF-PHIs (mean age: 74 years). Patients who switched had numerically higher mean erythropoietin resistance index (ERI) and numerically lower hemoglobin than those who continued ESA treatment. Mean hemoglobin levels increased following switching (9.9 g/dL vs. 10.6 g/dL; p = 0.004). After 3 months, hemoglobin levels increased in both high and low ERI subgroups (high ERI: 9.7 g/dL to 11.1 g/dL, low ERI: 10.6 g/dL to 11.8 g/dL). Hemoglobin levels did not notably decrease before or after the start of hemodialysis in two HIF-PHI-treated patients.

conclusionsPatients who switched to HIF-PHIs had low hemoglobin levels and high ERI compared with those who continued ESA treatment. Both high ERI and low ERI groups had increased hemoglobin levels after switching.

trial registrationUMIN Clinical Trials Registry (UMIN000022145, registration date: 30 April 2016).

Indexed as

AnemiaDrug SubstitutionHematinicsHypoxia-Inducible Factor-Proline DioxygenasesProlyl-Hydroxylase InhibitorsRenal Insufficiency, ChronicAgedAged, 80 and overCohort StudiesFemaleHemoglobinsHumansMaleMiddle AgedProspective StudiesTreatment OutcomeHematinicsHemoglobinsHypoxia-Inducible Factor-Proline DioxygenasesProlyl-Hydroxylase InhibitorsAnemia in chronic kidney diseaseErythropoiesis-stimulating agentsHIF-PH inhibitors

Identifiers

PMID42185975
PMCPMC13383514

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.