Abstract: TH-OR029
Effect of Ferric Citrate vs. Ferrous Sulfate on Iron, Hemoglobin, and Mineral Metabolism in CKD
Session Information
- Anemia and Iron Metabolism: Clinical Research
November 07, 2019 | Location: 150, Walter E. Washington Convention Center
Abstract Time: 06:06 PM - 06:18 PM
Category: Anemia and Iron Metabolism
- 202 Anemia and Iron Metabolism: Clinical
Authors
- Womack, Rebecca L., University of Alabama at Birmingham, Birmingham, Alabama, United States
- Panwar, Bhupesh, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Gutierrez, Orlando M., UAB School of Medicine, Birmingham, Alabama, United States
Background
Iron deficiency is common in CKD. Ferric citrate is a novel oral agent for treating iron deficiency anemia in CKD, but little is known about the efficacy of ferric citrate vs. ferrous sulfate (standard of care) in improving iron levels in CKD patients with iron deficiency.
Methods
60 patients with stage 3b-4 CKD and iron deficiency (transferrin saturation [TSAT] <30% and ferritin <300 ng/ml) were randomized to ferric citrate (FC; n=30,2 grams tid with meals) or ferrous sulfate (FS; n=30,325 mg po tid) for 12 weeks. Primary outcomes were change in TSAT and ferritin. Secondary outcomes were change in hemoglobin, phosphate, and FGF23.
Results
There were no significant differences in baseline characteristics by treatment arm except FGF23, which was higher in the FS vs. FC arm (Table 1). A total of 25 patients in the FC arm and 26 patients in the FS completed all visits. There were no significant changes in TSAT or phosphate in either arm. Serum ferritin and hemoglobin significantly increased in the FC but not the FS arm (Fig.1). Intact FGF23 decreased 19% in the FC arm (P<0.001) and 3% in the FS arm (P=0.33), and c-terminal FGF23 decreased 15% in the FC arm (P=0.08) and 14% in the FS (P=0.01) arm after 12 weeks. Adverse events were similar in both arms, and mostly involved gastrointestinal complaints.
Conclusion
As compared to FS, treatment with FC resulted in greater increases in ferritin and hemoglobin and a greater decrease in intact FGF23 in CKD patients.
Funding
- Commercial Support –