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Long-term efficacy and safety of iron-based phosphate binders, ferric citrate hydrate and sucroferric oxyhydroxide, in hemodialysis patients

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

Iron-based phosphate binders, including ferric citrate hydrate (FCH) and sucroferric oxyhydroxide (SFOH), have been used for the treatment of hyperphosphatemia in end-stage renal disease patients on dialysis. However, the long-term efficacy and safety of these agents have not yet been clearly elucidated.

Methods

Laboratory data of 56 hemodialysis patients who had been prescribed either FCH (n = 33) or SFOH (n = 23) were retrospectively examined.

Results

We showed that both FCH and SFOH significantly and consistently decreased serum phosphate concentrations in the patients undergoing maintenance hemodialysis during the 36-month observation period. Serum levels of calcium, intact parathyroid hormone, as well as hemoglobin levels were unaltered. No overshoot of parameters of iron metabolism, such as transferrin saturation and serum ferritin levels, was observed, and serum ferritin level remained under 300 ng/mL in most patients. A trend towards decrease in the doses of erythropoiesis-stimulating agents used and frequency of intravenous iron use was observed in both treatment groups. No severe adverse drug reactions were observed in either the patients receiving FCH or SFOH.

Conclusion

The results of the present study suggest that the iron-based phosphate binders, FCH and SFOH, decrease serum phosphate concentrations consistently and are safe to use over the long-term in maintenance hemodialysis patients.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank the medical doctors and their colleagues of Yotsuya Jin Clinic and Akihabara Izumi Clinic.

Funding

The study was not supported by any funding.

Author information

Authors and Affiliations

  1. Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Tadashi Yoshida, Kohkichi Morimoto & Mototsugu Oya

  2. Seigakai Shibuya Station Clinic, Tokyo, Japan

    Noriko Kaburagi, Tomoko Yamashita Takemitsu & Norimasa Yamashita

  3. Seigakai Yoyogi Station Clinic, Tokyo, Japan

    Teppei Fujino, Tomoko Yamashita Takemitsu & Norimasa Yamashita

  4. Department of Urology, Keio University School of Medicine, Tokyo, Japan

    Mototsugu Oya

Authors
  1. Tadashi Yoshida
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  2. Kohkichi Morimoto
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  3. Noriko Kaburagi
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  4. Teppei Fujino
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  5. Tomoko Yamashita Takemitsu
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  6. Norimasa Yamashita
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  7. Mototsugu Oya
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Contributions

TY: principal project leader, conceived study, participated in design and coordination, read and approved the final manuscript; KM, NK, TF: collected and analyzed the data, helped to draft manuscript, read and approved the final manuscript; TYT, NY, MO: participated in design and coordination, read and approved the final manuscript.

Corresponding author

Correspondence to Tadashi Yoshida.

Ethics declarations

Conflict of interest

T.Y. received research funding from Torii Pharmaceutical Co., Ltd. and Kissei Pharmaceutical Co., Ltd. The other authors do not have any conflicts of interest.

Ethical approval

The study protocol was approved by the Ethics Committees of Keio University School of Medicine (IRB Approval Number: 20200041), Seigakai Shibuya Station Clinic (IRB Approval Number: 2020S01), and Seigakai Yoyogi Station Clinic (IRB Approval Number: 2020Y01).

Consent to participate/consent for publication

Written informed consent was obtained from all participants at Seigakai Shibuya Station Clinic, Seigakai Yoyogi Station Clinic, Yotsuya Jin Clinic, and Akihabara Izumi Clinic, but was waived for participants at Keio University Hospital.

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Yoshida, T., Morimoto, K., Kaburagi, N. et al. Long-term efficacy and safety of iron-based phosphate binders, ferric citrate hydrate and sucroferric oxyhydroxide, in hemodialysis patients. Int Urol Nephrol 54, 861–872 (2022). https://doi.org/10.1007/s11255-021-02952-1

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  • DOI: https://doi.org/10.1007/s11255-021-02952-1

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