Differential Impacts of Intravenous Iron Administration and Iron-Containing Phosphate Binders on Serum Intact Fibroblast Growth Factor 23 Levels

Hirokazu Honda; Kenji Tanaka; Tetsuo Michihata; Keigo Shibagaki; Toshitaka Yuza; Keiichi Hirao; Naohisa Tomosugi; Takanori Shibata

doi:10.1159/000496640

Differential Impacts of Intravenous Iron Administration and Iron-Containing Phosphate Binders on Serum Intact Fibroblast Growth Factor 23 Levels

Blood Purif. 2019:47 Suppl 2:63-69. doi: 10.1159/000496640. Epub 2019 Apr 3.

Authors

Hirokazu Honda¹, Kenji Tanaka², Tetsuo Michihata³, Keigo Shibagaki⁴, Toshitaka Yuza⁵, Keiichi Hirao⁶, Naohisa Tomosugi⁷, Takanori Shibata⁸

Affiliations

¹ Division of Nephrology, Department of Medicine, Showa University Koto Toyusu Hospital, Tokyo, Japan, hondah@med.showa-u.ac.jp.
² Division of Dialysis, Suiyukai Clinic, Nara, Japan.
³ Division of Dialysis, Ebara Clinic, Tokyo, Japan.
⁴ Shibagaki Dialysis Clinic Jiyugaoka, Tokyo, Japan.
⁵ Shibagaki Dialysis Clinic Kugahara, Tokyo, Japan.
⁶ Shibagaki Dialysis Clinic Togoshi, Tokyo, Japan.
⁷ Division of Systems Bioscience for Drug Discovery, Medical Research Institute, Kanazawa Medical University, Kanazawa, Japan.
⁸ Division of Nephrology, Department of Medicine, Showa University, School of Medicine, Tokyo, Japan.

PMID: 30943476
DOI: 10.1159/000496640

Abstract

Aims: This study assessed the impact of iron administration on serum fibroblast growth factor 23 (FGF23) levels.

Methods: Of 123 hemodialysis (HD) patients treated with erythropoiesis-stimulating agents, 22 received once-weekly intravenous iron and 17 received daily oral iron with iron-containing phosphate binders. Intact FGF23 and biomarkers of iron metabolism were measured from blood samples drawn before each HD session, at baseline and on days 3, 5, 7, and 14.

Results: Phosphate levels did not differ among the 3 groups during the 14-day period. Ferritin levels were significantly increased in both iron treatment groups compared with the non-iron treatment group, but changes in transferrin saturation levels were similar in the intravenous iron and non-iron groups. However, intact FGF23 levels were continuously higher in the intravenous iron group than those in the other groups.

Conclusion: Intravenous iron administration may influence intact FGF23 levels in HD patients independently of phosphate and iron metabolism.

Keywords: Erythropoiesis-stimulating agent therapy; Ferric citrate hydrate; Iron metabolism; Phosphate; Saccharated ferric oxide; Sucroferric oxyhydroxide.

MeSH terms

Administration, Intravenous
Aged
Anemia / blood
Anemia / drug therapy
Anemia / etiology
Female
Fibroblast Growth Factor-23
Fibroblast Growth Factors / blood*
Hematinics / therapeutic use
Humans
Iron / administration & dosage
Iron / therapeutic use*
Male
Middle Aged
Phosphates / blood*
Renal Dialysis* / adverse effects
Renal Insufficiency, Chronic / blood*
Renal Insufficiency, Chronic / complications
Renal Insufficiency, Chronic / therapy*

Substances

FGF23 protein, human
Hematinics
Phosphates
Fibroblast Growth Factors
Fibroblast Growth Factor-23
Iron