Safety and efficacy of ferric citrate in phosphate reduction and iron supplementation in patients with chronic kidney disease

Mei Yi Wu, Ying Chun Chen, Chun Hung Lin, Yun Chun Wu, Yu Kang Tu, Der Cherng Tarng

Research output: Contribution to journalArticle

Abstract

Ferric citrate has been reported to have the potential to reduce phosphate and increase iron availability in patients with chronic kidney disease. In the present study, we evaluated its safety and efficacy in phosphate reduction and iron supplementation in chronic kidney disease stage 3-5 requiring dialysis patients. We systematically searched for clinical trials published in PubMed, Medline, and Cochrane databases. Only randomized controlled trials on the effects of ferric citrate in chronic kidney disease stage 3-5 requiring dialysis patients were selected. The primary outcomes were changes in serum phosphate, calcium, and anemia-related parameters. The secondary outcomes were the adverse effects of ferric citrate. Nine studies providing data on 1755 patients were included in the meta-analysis. Ferric citrate significantly reduced serum phosphate compared with placebo (mean difference, -1.39; 95% confidence interval, -2.12 to -0.66) and had a non-inferior effect compared with active treatment. Furthermore, ferric citrate significantly improved hemoglobin, transferrin saturation and ferritin. Adverse effects of constipation did not differ significantly between ferric citrate and placebo or active treatment. This review provides evidence that ferric citrate effectively alleviates hyperphosphatemia and iron deficiency in patients with chronic kidney disease stage 3-5 requiring dialysis patients. However, the included studies did not have cardiovascular complications or mortality information and could not assess whether ferric citrate affected the risk of all-cause death or cardiovascular complications in patients with chronic kidney disease. Further studies are required to assess whether the long-term use of ferric citrate can reduce the risk of cardiovascular events and all-cause mortality.

Original languageEnglish
Pages (from-to)107283-107294
Number of pages12
JournalOncotarget
Volume8
Issue number63
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Chronic Renal Insufficiency
Iron
Phosphates
Safety
Dialysis
Placebos
Hyperphosphatemia
ferric citrate
Mortality
Constipation
Transferrin
Ferritins
Serum
PubMed
Meta-Analysis
Anemia
Cause of Death
Hemoglobins
Randomized Controlled Trials
Clinical Trials

Keywords

  • Anemia
  • Chronic kidney disease
  • Ferric citrate
  • Meta-analysis
  • Phosphate binder

ASJC Scopus subject areas

  • Oncology

Cite this

Safety and efficacy of ferric citrate in phosphate reduction and iron supplementation in patients with chronic kidney disease. / Wu, Mei Yi; Chen, Ying Chun; Lin, Chun Hung; Wu, Yun Chun; Tu, Yu Kang; Tarng, Der Cherng.

In: Oncotarget, Vol. 8, No. 63, 01.01.2017, p. 107283-107294.

Research output: Contribution to journalArticle

Wu, Mei Yi ; Chen, Ying Chun ; Lin, Chun Hung ; Wu, Yun Chun ; Tu, Yu Kang ; Tarng, Der Cherng. / Safety and efficacy of ferric citrate in phosphate reduction and iron supplementation in patients with chronic kidney disease. In: Oncotarget. 2017 ; Vol. 8, No. 63. pp. 107283-107294.
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