Initial side effects of roxadustat on thyroid function in patients undergoing hemodialysis

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>