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Abstract: SA-PO245

Ferric Citrate Hydrate on Anemia Management in Hyperphosphatemia Hemodialysis Patients with or Without Diabetes: ASTRIO Study Supplementary Analysis

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Yokoyama, Keitaro, Harumi Toriton Clinic of The Jikei University Hospital, Tokyo, Japan
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  • Nakayama, Masaaki, Tohoku University, St Luke's International Hospital, Sendai City, Japan
  • Kyoko, Ito, Torii Pharmaceutical Co., Ltd, Tokyo, Japan
  • Hirakata, Hideki, Fukuoka Renal Clinic, Fukuoka City, Japan
Background

It is reported that patients with diabetes in hemodialysis (HD) tend to be treated with higher ESA dose. The relationship is bi-directional, iron affects glucose metabolism and glucose metabolism affects iron metabolism pathway. In ASTRIO Study, Ferric Citrate Hydrate (FC) reduced dose of ESA. The effect of FC on anemia management in hemodialysis diabetes patients has not been extensively evaluated.

Methods

ASTRIO was a prospective, randomized, multicenter, 24-week study. 93 hyperphosphatemia HD patients who had been taking non-iron based phosphate binders (PBs) were randomized to FC group (n=48) or Control group (n=45). In Control, patients maintained treatment with their existing PBs. Serum P and Hb were controlled within 3.5 to 6.0 mg/dL and 10.0 to 12.0 g/dL, respectively. Oral iron was prohibited in Control group. Intravenous iron was permitted if iron replacement therapy was required, at the physician’s discretion. The primary endpoint was change in ESA dose from baseline to the end of treatment (EOT); we evaluated a stratified analysis for diabetes patients whose main underlying disease is diabetic nephropathy.

Results

Serum P and Hb were maintained in both groups. Regardless of whether patients have diabetes or not, ESA doses decreased in FC group.

Conclusion

The effect of FC on anemia management in hyperphosphatemia HD was comparable between diabetic and non-diabetic patients.