DOI: 10.12890/2026_007262

Roxadustat-associated cholestatic jaundice in haemodialysis patients with positive rechallenge

Authors

  • Xiaosu Ke Department of Nephrology, Guangdong Zhongnengjian Electric Power Hospital, Guangzhou, China; Department of Nephrology, Guangdong Sanjiu Brain Hospital, Guangzhou, China 0000-0002-4222-1712
  • Churong Liu Department of Rehabilitation Medicine, Guangdong Zhongnengjian Electric Power Hospital, Guangzhou, China; Department of Rehabilitation Medicine, Guangdong Sanjiu Brain Hospital, Guangzhou, China 0009-0005-1339-7961

kexiaosu@163.com

Keywords

Roxadustat, cholestatic jaundice, HIF-PHI, haemodialysis

Abstract

Roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, is widely used for anaemia in chronic kidney disease. While pivotal trials reported low risks of transaminase elevations, detailed clinical case reports substantiating a causal link with cholestatic jaundice remain scarce. We report a series of four haemodialysis patients who developed cholestatic jaundice after roxadustat initiation, characterized by predominant elevations of direct bilirubin and bile acids with persistently normal transaminases. Notably, two patients had positive rechallenges. Common causes of cholestasis were excluded, and biochemical recovery occurred after drug discontinuation. This case report suggests a causal association between roxadustat and cholestatic jaundice in haemodialysis patients and highlights the value of monitoring cholestatic parameters during therapy.

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References

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Published

2026-08-10

Issue

Vol. 13 No. 8 (2026)

Categories

How to Cite

1.
Ke X, Liu C. Roxadustat-associated cholestatic jaundice in haemodialysis patients with positive rechallenge. EJCRIM [Internet]. 2026 Aug. 10 [cited 2026 Nov. 3];13(8). Available from: https://ejcrim.com/index.php/ejcrim/article/view/7262