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Ther Adv Chronic Dis. 2015 Sep;6(5):252-63. doi: 10.1177/2040622315589934.

Managing hyperphosphatemia in patients with chronic kidney disease on dialysis with ferric citrate: latest evidence and clinical usefulness.

Author information

1
Department of Nephrology and Hypertension, Barzilai University Medical Center, 2 Hahistadrut St, Ashkelon 78278, Israel.
2
Division of Nephrology, Baylor College of Medicine, Houston, TX, USA.
3
Division of Nephrology and Hypertension, University of Cincinnati, Cincinnati, OH, USA.
4
Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, OH, USA.
5
Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA.
6
Department of Nephrology and Hypertension, University of Vermont Medical Group, Burlington, VT, USA.

Abstract

Ferric citrate is a novel phosphate binder that allows the simultaneous treatment of hyperphosphatemia and iron deficiency in patients being treated for end-stage renal disease with hemodialysis (HD). Multiple clinical trials in HD patients have uniformly and consistently demonstrated the efficacy of the drug in controlling hyperphosphatemia with a good safety profile, leading the US Food and Drug Administration in 2014 to approve its use for that indication. A concurrent beneficial effect, while using ferric citrate as a phosphate binder, is its salutary effect in HD patients with iron deficiency being treated with an erythropoietin-stimulating agent (ESA) in restoring iron that becomes available for reversing chronic kidney disease (CKD)-related anemia. Ferric citrate has also been shown in several studies to diminish the need for intravenous iron treatment and to reduce the requirement for ESA. Ferric citrate is thus a preferred phosphate binder that helps resolve CKD-related mineral bone disease and iron-deficiency anemia.

KEYWORDS:

efficacy; ferric citrate; hemodialysis; hyperphosphatemia; iron deficiency; safety

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