Hypoxia-inducible factor-prolyl hydroxylase inhibitor Roxadustat (FG-4592) reduces renal fibrosis in Dahl salt-sensitive rats

J Hypertens. 2024 Mar 1;42(3):497-505. doi: 10.1097/HJH.0000000000003623. Epub 2023 Nov 27.

Abstract

Objective: Although hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) inhibitors have been developed for the treatment of renal anemia, their effects on cardiac and renal dysfunction remain unknown. We previously reported on Dahl salt-sensitive rats, in a rat model of salt-sensitive hypertension, that exhibited anemia and impaired expression of duodenal iron transporters after the development of hypertensive cardiac and renal dysfunction. Therefore, we investigated the effects of Roxadustat (FG-4592), an HIF-PH inhibitor, on anemia, iron regulation, and cardiac and renal dysfunction in Dahl salt-sensitive rats.

Methods: Six-week-old male Dahl salt-sensitive rats were fed a normal or high-salt diet for 8 weeks. A further subset of Dahl salt-sensitive rats, that were fed a high-salt diet, was administered Roxadustat for 8 weeks.

Results: Dahl salt-sensitive rats fed a high-salt diet developed hypertension, cardiac and renal dysfunction, and anemia after 8 weeks of feeding. Roxadustat increased hemoglobin and serum erythropoietin levels in Dahl salt-sensitive rats fed a high-salt diet. With regard to the iron-regulating system, Roxadustat lowered hepatic hepcidin gene expression and increased the gene expression of duodenal iron transporters, such as cytochrome b and divalent metal transporter 1 , in Dahl salt-sensitive rats fed a high-salt diet. Roxadustat did not affect the development of hypertension and cardiac hypertrophy in Dahl salt-sensitive rats with a high-salt diet; however, Roxadustat treatment attenuated renal fibrosis in these rats.

Conclusions: Roxadustat ameliorated anemia with affecting the gene expression of the iron-regulating system, and did not affect cardiac hypertrophy but attenuated renal fibrosis in Dahl salt-sensitive rats fed a high-salt diet.

MeSH terms

  • Anemia* / drug therapy
  • Anemia* / etiology
  • Animals
  • Cardiomegaly
  • Fibrosis
  • Hypertension* / genetics
  • Hypoxia
  • Iron
  • Male
  • Procollagen-Proline Dioxygenase
  • Prolyl Hydroxylases
  • Prolyl-Hydroxylase Inhibitors* / pharmacology
  • Rats
  • Rats, Inbred Dahl
  • Renal Insufficiency, Chronic*
  • Sodium Chloride, Dietary

Substances

  • Prolyl Hydroxylases
  • Prolyl-Hydroxylase Inhibitors
  • Procollagen-Proline Dioxygenase
  • Sodium Chloride, Dietary
  • Iron