Effects of intravenous iron on fibroblast growth factor 23 (FGF23) in haemodialysis patients: a randomized controlled trial

摘要: Intravenous iron affects serum levels of intact fibroblast growth factor-23 (iFGF23) and its cleavage product c-terminal FGF23 (cFGF23) in iron-deficient people with normal renal function. We hypothesized that intravenous modulates iFGF23 cFGF23 haemodialysis patients differently according to the type used. Prevalent, stable requiring protocol-based therapy were randomized a single 200 mg dose either ferric carboxymaltose (FCM) or sucrose (IS). The primary outcome was change from pre-infusion Day 2 post-infusion. Serum hepcidin, ferritin phosphate also measured. Pair-wise comparisons utilised Wilcoxon rank sum test; linear mixed models an interaction term for treatment time evaluated between-group effects. Forty-two participants completed study. In those FCM (n = 22), median (interquartile range) values 2, respectively, 843 pg/mL (313–1922) 576 pg/mL (356–1296, p = 0.05) iFGF23, 704RU/mL (475–1204) 813RU/mL (267–1156, p = 0.04) cFGF23, 1.53 mmol/L (1.14–1.71) 1.37 (1.05–1.67, p = 0.03) phosphate. These parameters did not following IS. Both (p < 0.001) hepcidin increased both groups, increase greater group (p = 0.03 difference). Contrary function, given protocol-driven demonstrated fall rise changes evident This suggests differential effect formulation Australian New Zealand Clinical Trials Register ACTRN12614000548639 . Registered 22 May 2014 (retrospectively registered).