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Review
. 2024 Mar 7:15:1285012.
doi: 10.3389/fphar.2024.1285012. eCollection 2024.

Ferric citrate for the treatment of hyperphosphatemia and iron deficiency anaemia in patients with NDD-CKD: a systematic review and meta-analysis

Xueying Ding  1 , Shujie Sun  1 , Jinjin Zhang  1 , Huifang Zhao  1 , Fenglan Lun  1 , Xuemin Liu  1 , Yiwan Zhen  1 , Jinping Dong  1 , Jingliang Wu  1
Affiliations
Review

Ferric citrate for the treatment of hyperphosphatemia and iron deficiency anaemia in patients with NDD-CKD: a systematic review and meta-analysis

Xueying Ding et al. Front Pharmacol. .

Abstract

Background: The application of ferric citrate therapy has yielded unexpected benefits in recent years for Chronic kidney disease patients suffering from hyperphosphatemia and iron deficiency -anaemia. Despite this, earlier research on the impact of ferric citrate on NDD-CKD has been contentious. Objective: The goal of the meta-analysis is to evaluate the evidence regarding the advantages and dangers of ferric citrate for the treatment of hyperphosphatemia and iron deficiency anaemia in NDD-CKD patients. Methods: Between the start of the study and June 2022, we searched PubMed, Embase, Cochrane, EBSCO, Scopus, Web of Science, Wan Fang Data, CNKI, and VIP databases for randomised controlled trials of iron citrate for hyperphosphatemia and anaemia in patients with NDD-CKD. For binary categorical data, risk ratios (OR) were employed, and for continuous variables, weighted mean differences The effect sizes for both count and measurement data were expressed using 95% confidence intervals Results: The meta-analysis includes eight trials with a total of 1281 NDD-CKD patients. The phosphorus-lowering effect of ferric citrate was greater compared to the control group (WMD, -0.55, 95% CI, -0.81 to -0.28; I2 = 86%, p < 0.001). Calcium (WMD, 0.092; 95% CI, -0.051 to 0.234; p > 0.05; I2 = 61.9%), PTH (WMD, -0.10; 95% CI, -0.44 to 0.23; I2 = 75%, p > 0.05) and iFGF23 (WMD, -7.62; 95% CI, -21.18 to 5.94; I2 = 20%, p > 0.05) levels were not statistically different after ferric citrate treatment compared to control treatment. Furthermore, ferric citrate increased iron reserves and haemoglobin. The ferric citrate group had considerably greater levels than the controls. Ferric citrate, on the other hand, may raise the risk of constipation, diarrhoea, and nausea. Conclusion: This meta-analysis found that ferric citrate had a beneficial effect in the treatment of NDD-CKD, particularly in reducing blood phosphorus levels when compared to a control intervention. It also shown that ferric citrate has a favourable effect on iron intake and anaemia management. In terms of safety, ferric citrate may increase the likelihood of gastrointestinal side effects.

Keywords: chronic kidney disease; ferric citrate; hyperphosphatemia; iron deficiency anaemia; meta.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study selection process.
FIGURE 2
FIGURE 2
Risk of bias graph.
FIGURE 3
FIGURE 3
Risk of bias summary.
FIGURE 4
FIGURE 4
Forest plot of the correlation between hyperphosphatemia and ferric citrate in NDD-CKD patients: (A) Changes in serum phosphorus; (B) Changes in serum calcium; (C) Changes in PTH; (D) Changes in iFGF23.
FIGURE 5
FIGURE 5
Subgroup analysis of daily doses of ferric citrate.
FIGURE 6
FIGURE 6
Forest plot of the correlation between iron deficiency anaemia and ferric citrate in NDD-CKD patients: (A) Changes in iron; (B) Changes in haemoglobin; (C) Changes in ferritin; (D) Changes in TSAT.
FIGURE 7
FIGURE 7
The forest plot shows adverse event.
FIGURE 8
FIGURE 8
Funnel plot of ferritin.
See this image and copyright information in PMC

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References

    1. Adejumo O. A., Okaka E. I., Madumezia G., Okwuonu C. G., Ojogwu L. I. (2015). Assessment of some cardiovascular risk factors in predialysis chronic kidney disease patients in Southern Nigeria. Niger. Med. J. J. Niger. Med. Assoc. 56 (6), 394–399. 10.4103/0300-1652.171616 - DOI - PMC - PubMed
    1. Baluarte J. H. (2017). Neurological complications of renal disease. Seminars Pediatr. neurology 24 (1), 25–32. 10.1016/j.spen.2016.12.004 - DOI - PubMed
    1. Batchelor E. K., Kapitsinou P., Pergola P. E., Kovesdy C. P., Jalal D. I. (2020). Iron deficiency in chronic kidney disease: updates on pathophysiology, diagnosis, and treatment. J. Am. Soc. Nephrol. JASN 31 (3), 456–468. 10.1681/ASN.2019020213 - DOI - PMC - PubMed
    1. Bazeley J. W., Wish J. B. (2022). Recent and emerging therapies for iron deficiency in anemia of CKD: a review. Am. J. kidney Dis. official J. Natl. Kidney Found. 79 (6), 868–876. 10.1053/j.ajkd.2021.09.017 - DOI - PubMed
    1. Beng-Ongey H., Robinson J. S., Moxey-Mims M. (2022). Chronic kidney disease emerging trends in children and what to do about it. J. Natl. Med. Assoc. 114 (3s2), S50–s55. 10.1016/j.jnma.2022.05.002 - DOI - PubMed

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