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Kidney Week

Abstract: PO0255

Triferic (Ferric Pyrophosphate Citrate, FPC) Maintains Hemoglobin and Reduces IV Iron: Results from a Single-Site 2-Year Observational Analysis

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism


  • Hoffman, Marc L., Rockwell Medical Inc, Wixom, Michigan, United States
  • Delvalle, Richard, Center for Renal Replacement, LLC, Lincolnwood, Illinois, United States
  • Pratt, Raymond D., Rockwell Medical Inc, Wixom, Michigan, United States

Triferic (ferric pyrophosphate citrate, FPC) is approved as an iron (Fe) replacement product to maintain hemoglobin (Hgb) in adult patients (pts) receiving chronic hemodialysis (HD).Trial data have demonstrated that FPC maintains Fe stores and Hgb while reducing IV Fe usage with a well-tolerated safety profile. We now report one clinic’s experience using FPC for all HD patients (pts) during a 2 yr period.


FPC was added to centrally delivered liquid bicarbonate to provide 110 µg Fe/L dialysate. All patients received FPC at each HD. Anonymized retrospective data from the electronic health record were collected between Sep 2016--Dec 2018. A recommended FPC Fe protocol was provided, but the clinic was allowed to adjust anemia management at their discretion. Supplemental Fe gluconate (IV Fe) was administered according to a protocol based on serum ferritin and TSAT values. All pts receiving IV Fe received single doses of 125 mg elemental Fe up to a max of 500 mg Fe/month when criteria for supplementation was met. During the first 4 months of FPC, the center converted pts from epoetin alfa (EPO) to darbepoetin alfa (INN), therefore INN equivalents were calculated using the published conversion guide (EPO dose/300). IV iron and ESA dose were standardized and changes from pre-FPC were reported for Hgb, IV Fe and ESA usage. KDQoL data were available for the years 2016--2018.


Within 3 months of initiation of FPC, Hgb increased by 0.3 g/dL and was maintained during the observation period. Total IV Fe dose was significantly reduced by 78.4%. Darbepoetin equivalent doses were reduced from pre-FPC by 31.5% by the end of the observation period. Compared to the first year of assessments (2016), post FPC assessments of QoL showed improvements in the Burden of Kidney Disease (KD), Symptoms and Problems of KD and Effects of KD on daily life scales. No adverse events related to FPC were reported.


This observational study demonstrates that FPC is a well tolerated replacement for IV Fe when administered to all patients in a HD unit. The findings of this real-world observational study align with those of clinical trials in terms of reduction of IV Fe use and maintenance of Hgb. ESA was gradually reduced and the KDQoL showed a trend to improvement in the burden and symptoms of kidney disease.


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