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2018 ; 3
(2
): 364-373
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Oral Ferric Citrate Hydrate Associated With Less Oxidative Stress Than
Intravenous Saccharated Ferric Oxide
#MMPMID29725640
Nakayama M
; Tani Y
; Zhu WJ
; Watanabe K
; Yokoyama K
; Fukagawa M
; Akiba T
; Wolf M
; Hirakata H
Kidney Int Rep
2018[Mar]; 3
(2
): 364-373
PMID29725640
show ga
INTRODUCTION: A recent study suggested that orally dosed ferric citrate hydrate
(FC) corrects renal anemia in patients on hemodialysis (HD), suggesting
biological differences in effects of iron supplementation using different routes
of administration. To address this issue, the present study compared oral FC with
i.v. saccharated ferric oxide (FO) in stable HD patients. METHODS: Participants
comprised 6 patients administered 3 consecutive protocols in the first HD session
of the week in a fasting state: nothing given, as control (C); oral load of FC
(480 mg iron), and 5 minutes of i.v. FO (40 mg iron). Iron dynamics in the body
and biological impact on redox-inflammation status during the study (6 hours)
were examined. RESULTS: Significant increases in serum iron and transferrin
saturation were seen with both FC and FO. Regarding total iron-binding capacity
as the sum of serum iron and unsaturated iron-binding capacity, no changes were
found in FC, whereas significant increases were seen in FO (appearance of
non-transferrin-binding iron [NTBI]), despite the lower serum iron levels in FO.
Compared with C, increases were seen in serum myeloperoxidase (oxidative marker)
with accompanying significant decreases in thioredoxin (antioxidant) in FO,
whereas no changes were found in FC. CONCLUSION: Oral FC differs from i.v. FO in
areas such as less NTBI generation and less induction of oxidative stress. The
result indicates potential clinical benefits of oral FC in terms of iron
supplementation for renal anemia in HD patients.
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