Publication Date
2014
Journal Title
Am J Kidney Dis
Abstract
BACKGROUND: Iron deficiency anemia and serum phosphate levels > 4.0mg/dL are relatively common in chronic kidney disease stages 3 to 5 and are associated with higher risks of progressive loss of kidney function, cardiovascular events, and mortality. STUDY DESIGN: Double-blind, placebo-controlled, randomized trial. SETTING & PARTICIPANTS: 149 patients with estimated glomerular filtration rates < 60mL/min/1.73m2, iron deficiency anemia (hemoglobin, 9.0-12.0g/dL; transferrin saturation [TSAT]/= 4.0 to 6.0mg/dL. Use of intravenous iron or erythropoiesis-stimulating agents was prohibited. INTERVENTION: Randomization to treatment for 12 weeks with ferric citrate coordination complex (ferric citrate) or placebo. OUTCOMES & MEASUREMENTS: Coprimary end points were change in TSAT and serum phosphate level from baseline to end of study. Secondary outcomes included change from baseline to end of treatment in values for ferritin, hemoglobin, intact fibroblast growth factor 23 (FGF-23), urinary phosphate excretion, and estimated glomerular filtration rate. RESULTS: Ferric citrate treatment increased mean TSAT from 22% +/- 7% (SD) to 32% +/- 14% and reduced serum phosphate levels from 4.5+/-0.6 to 3.9+/-0.6mg/dL, while placebo exerted no effect on TSAT (21% +/- 8% to 20% +/- 8%) and less effect on serum phosphate level (4.7+/-0.6 to 4.4+/-0.8mg/dL; between-group P
Volume Number
65
Issue Number
5
Pages
728-736
Document Type
Article
EPub Date
2014/12/04
Status
Faculty
Facility
School of Medicine
Primary Department
Nephrology
PMID
DOI
10.1053/j.ajkd.2014.10.014