Roxadustat-induced central hypothyroidism in hemodialysis patients: a report of two cases

Hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) is a novel class of oral medications for treating renal anemia, but adverse drug events have been reported both in China and internationally in recent years. This article reports two cases of reversible central hypothyroidism following the administration of the HIF-PHI roxadustat in patients undergoing regular hemodialysis with end-stage renal disease. Both patients gradually developed non-specific discomfort symptoms after one year of oral roxadustat treatment. Laboratory tests revealed abnormal thyroid function, while cranial magnetic resonance imaging showed no abnormalities. After discontinuation of roxadustat, thyroid function returned to normal and the symptoms resolved. These two cases suggest that it is necessary to monitor thyroid function in patients receiving oral roxadustat for renal anemia.