Breakdown of 3OH-pyruvate in REC cells leads to Roxadustat-induced serine synthesis and gluconeogenesis. (A) Schematic representation of metabolic pathways involving catabolism and utilization of 3OH-pyruvate in REC cells that are particularly enhanced in the presence of Roxadustat (↑FG or ↑↑↑FG in case of 3-phosphoglycerate). (B) Roxadustat-induced changes of select metabolites in 3OH-pyruvate–treated REC cells expressed as fold-change versus untreated control (dashed line). 3PGlyc, glyceric acid-3-phosphate; Citr, citric acid; Gluc, glucose; Gly, glycine; Ileu, isoleucine; Leu, leucine; Pro, proline; Ser, serine; Thr, threonine; Val, valine.