Roxadustat for anemia in chronic kidney disease: how patients on dialysis and those not on dialysis can prepare

EastMedGo Nov 6, 2026

If your kidney function has declined and you have developed anemia, first ask your nephrology team to review your hemoglobin trend, iron stores, and other possible causes, such as blood loss. Roxadustat is an oral medicine. In China, it was first approved in December 2018 for anemia in chronic kidney disease in patients on dialysis, and its approval was extended to patients not on dialysis in August 2019. Whether it is suitable for you depends on your current dialysis, iron supplementation, and treatment to stimulate red blood cell production.

Key points

Keep your hemoglobin and iron test results together on the same timeline.
Ask about the date of your first blood test after switching medicines, especially if you have just changed treatment or plan to leave the country.

Which test results help identify the cause?

Bring your complete blood count, recent hemoglobin results, ferritin, and transferrin saturation. Also mention heavy menstrual bleeding, black stools, recent surgery or hospitalization, infection, or difficulty tolerating iron supplements. If you are on dialysis, bring details of the dialysis method, your current schedule, and medication records from your dialysis center. If you have ongoing blood loss or iron deficiency, your doctor will need to investigate and address the cause at the same time.

What should you ask first when switching from your current treatment?

Tell your nephrology team which medicine you last used to stimulate red blood cell production, when it was given, and your recent doses, as well as how you take oral iron or receive intravenous iron. Ask your doctor to write down when the old treatment ends, which days to take the new medicine, and how to space it apart from other medicines. The starting dose of roxadustat and subsequent adjustments depend on your dialysis status, previous medicines, and laboratory results. Do not use another patient's prescription.

How to assess medicine prices and ongoing laboratory costs

In China, the original-brand 爱瑞卓 capsules cost CNY 52.29 per box for 20 mg×3 capsules and CNY 105.45 per box for 50 mg×3 capsules. Calculate the cost using the capsule strength, number of capsules per dose, and number of doses per week on your prescription, then add the costs of follow-up complete blood counts and iron studies.

Who will review your hemoglobin results after you return home?

After treatment starts, the prescribing information recommends checking hemoglobin every two weeks, then every four weeks once it is stable. Your doctor will schedule follow-up tests based on the results and the timing of dose adjustments. Take home your target range, the date of your most recent dose adjustment, and contact details for the clinic that will receive your reports. If you have chest pain, sudden shortness of breath, or fainting, seek emergency care promptly rather than waiting for routine blood tests.

Frequently asked questions

Does a low hemoglobin level mean I have anemia caused by kidney disease?

Your kidney function at the time and other possible causes, especially blood loss or iron deficiency, also need to be considered. A single low result is not enough to decide whether to start this medicine.

I receive injections at my dialysis center. What should I bring to this hospital visit?

Bring the name of the injected medicine, the date of your most recent dose, the dose, and your last several hemoglobin results so your doctor can decide whether to continue or switch treatment.

Does a box of three capsules mean I will always need just one box per week?

The number of capsules you need depends on the dose each time and the capsule strength. Use your written prescription to calculate how many capsules you need each week.

Do I still need iron supplements?

List all your oral and intravenous iron products for your doctor. Whether to continue or adjust them, and how to schedule them with other oral medicines, depends on your iron test results and prescription.

Can I continue having tests at my local dialysis center after one follow-up visit?

First agree on which laboratory will perform the blood tests and which doctor will review the results and change your prescription, then pass on the records from your care team in China.