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Abstract: PO0380

Assessment of Serum Phosphorus Levels in Patients Following Administration of Ferric Pyrophosphate Citrate: A Retrospective Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Brooker, David Michael, Grace Hospital, Morganton, North Carolina, United States
  • Brooker, David R., Brooker Kidney Care, Cranberry, Pennsylvania, United States
  • Ayyash, Ali M., Grace Hospital, Morganton, North Carolina, United States
  • Chait, Yossi, University of Massachusetts Amherst Department of Mechanical and Industrial Engineering, Amherst, Massachusetts, United States
  • Nathanson, Brian Harris, OptiStatim, LLC, Longmeadow, Massachusetts, United States
  • Germain, Michael J., Div of Nephrology, Baystate Medical Center, Springfield, Massachusetts, United States

Iron deficiency is common among hemodialysis patients contributing to chronic anemia. Ferric pyrophosphate citrate (FPC) is FDA-approved to replace iron and maintain hemoglobin in adult hemodialysis patients by delivering iron directly and rapidly to transferrin. FPC is a mixed-ligand iron complex in which iron is bound to pyrophosphate and citrate, along with containing phosphate, sodium, and sulfate. Phosphorus regulation in ESRD patients can be challenging thus administering products containing phosphates risks increasing serum phosphorus in addition to exacerbating underlying endocrine abnormalities. The objective of this study is to assess any changes in phosphorus levels in hemodialysis patients receiving FPC.


Retrospective data from patients at a single center hemodialysis clinic was reanalyzed looking at serum phosphorus level of hemodialysis patients receiving FPC over a one-year span of time. The data analyzed included serum phosphorus levels prior to initiating therapy compared to serum phosphorus levels after being administered FPC 1-month, 6-months, and 12-months on therapy.


Forty-nine patients were included in the study. Median serum phosphorous values were at pre-therapy (median 4.8), 1-month of FPC (median 4.7, p=0.56), 6-months of FPC (median 4.8, p=0.49), and 12-months of FPC (median 5.1, p=0.36) as represented in Figure 1.


After analysis of serum phosphorus levels in hemodialysis patients receiving ferric pyrophosphate citrate, the findings show that there was no difference in average serum phosphorus levels before and after therapy. Clinicians who are prescribing this medication should be aware that there is no increase in serum phosphorus in patients while receiving this therapy considering how difficult it can be to regulate phosphorus along with managing the potential consequences of phosphorus abnormalities.

Figure 1