Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials
Background Hyperphosphatemia and anemia, which are common complications of chronic kidney disease (CKD), can independently contribute to cardiovascular events. Several previous studies have found that the iron-based phosphate binder, ferric citrate (FC), could be beneficial to both hyperphosphatemia...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2094273 |
| _version_ | 1818492005078007808 |
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| author | Li Li Xin Zheng Jin Deng Junlin Zhou Jihong Ou Tao Hong |
| author_facet | Li Li Xin Zheng Jin Deng Junlin Zhou Jihong Ou Tao Hong |
| author_sort | Li Li |
| collection | DOAJ |
| description | Background Hyperphosphatemia and anemia, which are common complications of chronic kidney disease (CKD), can independently contribute to cardiovascular events. Several previous studies have found that the iron-based phosphate binder, ferric citrate (FC), could be beneficial to both hyperphosphatemia and anemia.Methods Relevant literature from PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials (CCRCT) and MEDLINE databases were searched up to 21 February 2022, in order to conduct a meta-analysis to investigate the efficacy, safety and economic benefits of ferric citrate treatment in CKD patients with hyperphosphatemia and anemia. The meta-analysis was conducted independently by two reviewers using the RevMan software (version 5.3).Results In total, this study included 16 randomized clinical trials (RCT) involving 1754 participants. The meta-analysis showed that ferric citrate could significantly reduce the serum phosphorus in CKD patients compared to the placebo control groups (MD −1.76 mg/dL, 95% CI (−2.78, −0.75); p = 0.0007). In contrast, the difference between ferric citrate treatment and active controls, such as non-iron-based phosphate binders, sevelamer, calcium carbonate, lanthanum carbonate and sodium ferrous citrate, was not statistically significant (MD − 0.09 mg/dL, 95% CI (−0.35, 0.17); p = 0.51). However, ferric citrate could effectively improve hemoglobin levels when compared to the active drug (MD 0.43 g/dL, 95% CI (0.04, 0.82); p = 0.03) and placebo groups (MD 0.39 g/dL, 95% CI (0.04, 0.73); p = 0.03). According to eight studies, ferric citrate was found to be cost-effective treatment in comparison to control drugs. Most of the adverse events (AE) following ferric citrate treatment were mild at most.Conclusion Collectively, our review suggests that iron-based phosphate binder, ferric citrate is an effective and safe treatment option for CKD patients with hyperphosphatemia and anemia. More importantly, this alternative treatment may also less expensive. Nevertheless, more scientific studies are warranted to validate our findings. |
| first_indexed | 2024-12-10T17:37:57Z |
| format | Article |
| id | doaj.art-da445a20b45841e4a98d5754272ba2da |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-12-10T17:37:57Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-da445a20b45841e4a98d5754272ba2da2022-12-22T01:39:29ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492022-12-014411112112210.1080/0886022X.2022.2094273Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trialsLi Li0Xin Zheng1Jin Deng2Junlin Zhou3Jihong Ou4Tao Hong5The First Affiliated Hospital, Hengyang Medical School, Department of Nephrology, University of South China, Hengyang, China, Hengyang, ChinaDepartment of Nephrology, Zhuzhou Central Hospital, Zhuzhou, ChinaThe First Affiliated Hospital, Hengyang Medical School, Department of Nephrology, University of South China, Hengyang, China, Hengyang, ChinaThe First Affiliated Hospital, Hengyang Medical School, the Health Management Center, University of South China, Hengyang, China, Hengyang, ChinaThe First Affiliated Hospital, Hengyang Medical School, Department of Nephrology, University of South China, Hengyang, China, Hengyang, ChinaThe Second Affiliated Hospital, Hengyang Medical School, Department of Endocrinology and Metabolism, University of South China, China, Hengyang, ChinaBackground Hyperphosphatemia and anemia, which are common complications of chronic kidney disease (CKD), can independently contribute to cardiovascular events. Several previous studies have found that the iron-based phosphate binder, ferric citrate (FC), could be beneficial to both hyperphosphatemia and anemia.Methods Relevant literature from PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials (CCRCT) and MEDLINE databases were searched up to 21 February 2022, in order to conduct a meta-analysis to investigate the efficacy, safety and economic benefits of ferric citrate treatment in CKD patients with hyperphosphatemia and anemia. The meta-analysis was conducted independently by two reviewers using the RevMan software (version 5.3).Results In total, this study included 16 randomized clinical trials (RCT) involving 1754 participants. The meta-analysis showed that ferric citrate could significantly reduce the serum phosphorus in CKD patients compared to the placebo control groups (MD −1.76 mg/dL, 95% CI (−2.78, −0.75); p = 0.0007). In contrast, the difference between ferric citrate treatment and active controls, such as non-iron-based phosphate binders, sevelamer, calcium carbonate, lanthanum carbonate and sodium ferrous citrate, was not statistically significant (MD − 0.09 mg/dL, 95% CI (−0.35, 0.17); p = 0.51). However, ferric citrate could effectively improve hemoglobin levels when compared to the active drug (MD 0.43 g/dL, 95% CI (0.04, 0.82); p = 0.03) and placebo groups (MD 0.39 g/dL, 95% CI (0.04, 0.73); p = 0.03). According to eight studies, ferric citrate was found to be cost-effective treatment in comparison to control drugs. Most of the adverse events (AE) following ferric citrate treatment were mild at most.Conclusion Collectively, our review suggests that iron-based phosphate binder, ferric citrate is an effective and safe treatment option for CKD patients with hyperphosphatemia and anemia. More importantly, this alternative treatment may also less expensive. Nevertheless, more scientific studies are warranted to validate our findings.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2094273Ferric citratehyperphosphatemiaanemiachronic kidney diseasemeta-analysis |
| spellingShingle | Li Li Xin Zheng Jin Deng Junlin Zhou Jihong Ou Tao Hong Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials Renal Failure Ferric citrate hyperphosphatemia anemia chronic kidney disease meta-analysis |
| title | Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials |
| title_full | Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials |
| title_fullStr | Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials |
| title_full_unstemmed | Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials |
| title_short | Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials |
| title_sort | ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease a meta analysis of randomized clinical trials |
| topic | Ferric citrate hyperphosphatemia anemia chronic kidney disease meta-analysis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2094273 |
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