Roxadustat attenuates contrast-induced acute kidney injury potentially mediated via the Nrf2/HO-1 signaling pathway.

Roxadustat (ROX) has a protective action against contrast-induced acute kidney injury (CI-AKI). Excessive production of reactive oxygen species (ROS) plays a significant role in exacerbating the deterioration of renal function. Notably, activation of Nrf2/HO-1 signaling can reduce ROS production. We constructed a mouse model of CI-AKI by iohexol injection. The effect of ROX on CI-AKI was assessed by measuring serum blood urea nitrogen (BUN) and creatinine (Cr), evaluating renal histopathology, and analyzing the expression level of Nrf2 and HO-1. Additionally, levels of ROS, malondialdehyde (MDA), proinflammatory cytokines (IL-6, TNF-α, and IL-1β), as well as the activities of antioxidant kinases superoxide dismutase (SOD) and glutathione (GSH), were examined. The results showed that ROX significantly suppresses the iohexol-induced decline in the activity of antioxidant enzymes, increases the levels of ROS, MDA, Cr, IL-6, IL-1β, BUN and TNF-α, and attenuates renal pathological injury. Furthermore, ROX enhanced the iohexol-induced increase in Nrf2 and HO-1 expression. However, these effects of ROX on CI-AKI were abolished by ML-385, a Nrf2 inhibitor. Our findings indicate ROX attenuates CI-AKI by down-regulating inflammation and restoring the balance between oxidative stress and anti-oxidant defenses. This may involve the activation of the Nrf2/HO-1 signaling pathway to clear excessive ROS.