2015年
Administration of Ferric Citrate Hydrate Decreases Circulating FGF23 Levels Independently of Serum Phosphate Levels in Hemodialysis Patients with Iron Deficiency
NEPHRON
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- 巻
- 131
- 号
- 3
- 開始ページ
- 161
- 終了ページ
- 166
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1159/000440968
- 出版者・発行元
- KARGER
Background/Aim: Dietary phosphate intake and vitamin D receptor activator (VDRA) regulate fibroblast growth factor 23 (FGF23); iron may modulate FGF23 metabolism. We aimed to determine whether oral iron supplementation influences serum FGF23 concentration in hemodialysis (HD) patients, while excluding the effect of dietary phosphate intake. Methods: This prospective study enrolled 27 maintenance HD patients with iron deficiency and hyperphosphatemia treated with sevelamer-HCl. The phosphate binder was changed from sevelamer-HCl to ferric citrate hydrate (FCH) to maintain constant phosphate levels. VDRA, other phosphate binders, and cinacalcet HCl were not changed. Serum intact FGF23, C-terminal FGF23 (C-term FGF23), intact parathyroid hormone (PTH), 1,25(OH) 2 D and other parameters were monitored for 12 weeks. Results: Serum phosphate levels (5.89 +/- 1.45 mg/dl at baseline, 5.54 +/- 1.35 mg/dl at 12 weeks) and 1,25(OH) 2 D levels were unchanged. Serum ferritin levels increased from 25.6 +/- 24.3 ng/ml at baseline to 55.8 +/- 33.5 ng/ml at 12 weeks with FCH administration. Serum intact FGF23 and C-term FGF23 levels significantly decreased at 12 weeks compared with baseline (2,000 (1,300.0-3,471.4) to 1,771.4 (1,142.9-2,342.9) pg/ml, p = 0.01, and 1,608.7 (634.8-2,308.7) to 1,165.2 (626.1-1,547.8) RU/ml, p = 0.007, respectively); serum intact PTH levels significantly increased (96 (65-125) to 173 (114-283) pg/ml, p < 0.001). Conclusions: Oral FCH administration decreased serum intact FGF23 and C-term FGF23 levels and increased intact PTH levels; phosphate and 1,25(OH)(2)D levels were unchanged. Oral FCH administration to treat iron deficiency is a possible strategy for reducing serum FGF23 levels independent of phosphate and VDRA. (C) 2015 The Author(s) Published by S. Karger AG, Basel
- リンク情報
- ID情報
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- DOI : 10.1159/000440968
- ISSN : 1660-8151
- eISSN : 2235-3186
- PubMed ID : 26551233
- Web of Science ID : WOS:000365605400002