Oral Anemia Drug Matches Injection in Dialysis Trial
Adults on dialysis for kidney disease who need anemia treatment may gain an oral option dosed three times a week.
Updated on Nov. 5, 2026 in Stroke
Akebia Therapeutics reported topline results from its phase 3 VOCAL trial, testing oral vadadustat dosed three times weekly against an erythropoiesis-stimulating agent (ESA) in adults on outpatient hemodialysis for end-stage kidney disease. The drug met its noninferiority goal for maintaining hemoglobin levels, which is relevant to the many U.S. dialysis patients who manage anemia of chronic kidney disease.
Why it matters
Anemia is a common complication of chronic kidney disease, and treatment has traditionally relied on injectable ESAs given in clinic. An oral option dosed three times a week, aligned with dialysis schedules, could change how this anemia is managed for people already receiving in-center dialysis.
The VOCAL study was a phase 3 open-label randomized trial enrolling 353 adults receiving outpatient in-center hemodialysis for end-stage kidney disease. Vadadustat three times weekly met noninferiority to the ESA on the primary hemoglobin endpoint, with the lower confidence bound staying above the prespecified margin.
The players
Akebia Therapeutics
A biopharmaceutical company focused on kidney disease, whose treatments include the anemia drug vadadustat.
US Renal Care
A large U.S. dialysis provider that presented analysis of the separate VOICE trial at ASN Kidney Week.
The details
Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, a class of drug that stimulates the body's own erythropoietin response to increase red blood cell production. Participants were assigned at random to either the oral drug or methoxy polyethylene glycol-epoetin beta, an ESA. The primary endpoint measured the change in hemoglobin between baseline and the average of weeks 20 to 24. The drug is already approved under the brand name Vafseo as a once-daily treatment for anemia due to CKD.
Timeline
November 5, 2026: Akebia Therapeutics announced the VOCAL trial topline results.
Weeks 20 to 24: Period over which average hemoglobin was measured for the primary endpoint.
Health Landscape
Oral HIF prolyl hydroxylase inhibitors such as vadadustat offer an alternative to injectable ESAs, which have long been the standard of care for CKD anemia. The VOCAL result adds evidence on whether dosing aligned with dialysis sessions can match ESA performance.
If you are receiving dialysis for kidney disease and have been treated for anemia, this result is worth raising with your nephrology team, since it shows an oral option was tested against an existing injectable. Anyone with anemia related to CKD should ask a clinician whether newer treatment options could fit their care plan, rather than changing anything on their own.
The takeaway
An oral anemia treatment dosed three times weekly matched an injectable ESA on maintaining hemoglobin in this trial, which may broaden options for dialysis patients. Ask your nephrologist how anemia is currently managed in your care and whether oral alternatives are appropriate for you.
Further reading
For broader context on conditions affecting the kidneys and circulation, see our Stroke coverage.
