Oral ferrous citrate or ferrous sulfate use during predialysis may reduce serum phosphate level at dialysis initiation


Shigehisa Koide, Daijo Inaguma, Eri Koshi-Ito, Kazuo Takahashi, Hiroki Hayashi, Naotake Tsuboi, Midori Hasegawa, Yukio Yuzawa

Research output: Contribution to journalArticle

Abstract

AIM: Some reports claim that intravenous iron supplements reduce serum phosphate levels in patients with chronic kidney disease (CKD), including those on dialysis. However, whether divalent oral iron supplements influence serum phosphate levels in patients with CKD remains unclear; thus, this study aimed to address this topic. MATERIALS AND METHODS: The study database was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP), which is a multicenter, prospective, cohort study. Patients were classified into two groups: those who received iron orally (iron group, n = 255) from pre-dialysis to dialysis initiation and those who did not receive iron supplements (no-iron group, n = 1,261). Moreover, patients were classified into two groups (255 patients in each) by propensity score (PS) matching. We compared serum phosphate level at dialysis initiation and all-cause mortality. Multivariate regression analysis was used to extract factors contributing to serum phosphate level at dialysis initiation through a stepwise method. RESULTS: Serum phosphate levels at dialysis initiation were significantly lower in the iron group (all cohort, 6.0 ± 1.6 vs. 6.4 ± 1.9 mg/dL, p = 0.001; PS-matched cohort, 6.0 ± 1.6 vs. 6.5 ± 1.7 mg/dL, p = 0.001). Multivariate regression analysis revealed that oral iron supplementation was significantly correlated to serum phosphate level (p = 0.023). There were no significant differences in all-cause mortality after dialysis initiation. CONCLUSION: This study showed that oral ferrous citrate or ferrous sulfate use during predialysis was associated with differences in serum phosphate level at dialysis initiation.

Original languageEnglish
Pages (from-to)180-189
Number of pages10
JournalClinical nephrology
Volume92
Issue number4
DOIs
Publication statusPublished - 01-10-2019

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ferrous sulfate
Dialysis
Phosphates
Iron
Serum
Propensity Score
Chronic Renal Insufficiency
Cohort Studies
Multivariate Analysis
Regression Analysis
monoferrous acid citrate
Mortality

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Koide, Shigehisa ; Inaguma, Daijo ; Koshi-Ito, Eri ; Takahashi, Kazuo ; Hayashi, Hiroki ; Tsuboi, Naotake ; Hasegawa, Midori ; Yuzawa, Yukio. / Oral ferrous citrate or ferrous sulfate use during predialysis may reduce serum phosphate level at dialysis initiation
. In: Clinical nephrology. 2019 ; Vol. 92, No. 4. pp. 180-189.
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abstract = "AIM: Some reports claim that intravenous iron supplements reduce serum phosphate levels in patients with chronic kidney disease (CKD), including those on dialysis. However, whether divalent oral iron supplements influence serum phosphate levels in patients with CKD remains unclear; thus, this study aimed to address this topic. MATERIALS AND METHODS: The study database was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP), which is a multicenter, prospective, cohort study. Patients were classified into two groups: those who received iron orally (iron group, n = 255) from pre-dialysis to dialysis initiation and those who did not receive iron supplements (no-iron group, n = 1,261). Moreover, patients were classified into two groups (255 patients in each) by propensity score (PS) matching. We compared serum phosphate level at dialysis initiation and all-cause mortality. Multivariate regression analysis was used to extract factors contributing to serum phosphate level at dialysis initiation through a stepwise method. RESULTS: Serum phosphate levels at dialysis initiation were significantly lower in the iron group (all cohort, 6.0 ± 1.6 vs. 6.4 ± 1.9 mg/dL, p = 0.001; PS-matched cohort, 6.0 ± 1.6 vs. 6.5 ± 1.7 mg/dL, p = 0.001). Multivariate regression analysis revealed that oral iron supplementation was significantly correlated to serum phosphate level (p = 0.023). There were no significant differences in all-cause mortality after dialysis initiation. CONCLUSION: This study showed that oral ferrous citrate or ferrous sulfate use during predialysis was associated with differences in serum phosphate level at dialysis initiation.",
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Oral ferrous citrate or ferrous sulfate use during predialysis may reduce serum phosphate level at dialysis initiation
. / Koide, Shigehisa; Inaguma, Daijo; Koshi-Ito, Eri; Takahashi, Kazuo; Hayashi, Hiroki; Tsuboi, Naotake; Hasegawa, Midori; Yuzawa, Yukio.

In: Clinical nephrology, Vol. 92, No. 4, 01.10.2019, p. 180-189.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oral ferrous citrate or ferrous sulfate use during predialysis may reduce serum phosphate level at dialysis initiation


AU - Koide, Shigehisa

AU - Inaguma, Daijo

AU - Koshi-Ito, Eri

AU - Takahashi, Kazuo

AU - Hayashi, Hiroki

AU - Tsuboi, Naotake

AU - Hasegawa, Midori

AU - Yuzawa, Yukio

PY - 2019/10/1

Y1 - 2019/10/1

N2 - AIM: Some reports claim that intravenous iron supplements reduce serum phosphate levels in patients with chronic kidney disease (CKD), including those on dialysis. However, whether divalent oral iron supplements influence serum phosphate levels in patients with CKD remains unclear; thus, this study aimed to address this topic. MATERIALS AND METHODS: The study database was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP), which is a multicenter, prospective, cohort study. Patients were classified into two groups: those who received iron orally (iron group, n = 255) from pre-dialysis to dialysis initiation and those who did not receive iron supplements (no-iron group, n = 1,261). Moreover, patients were classified into two groups (255 patients in each) by propensity score (PS) matching. We compared serum phosphate level at dialysis initiation and all-cause mortality. Multivariate regression analysis was used to extract factors contributing to serum phosphate level at dialysis initiation through a stepwise method. RESULTS: Serum phosphate levels at dialysis initiation were significantly lower in the iron group (all cohort, 6.0 ± 1.6 vs. 6.4 ± 1.9 mg/dL, p = 0.001; PS-matched cohort, 6.0 ± 1.6 vs. 6.5 ± 1.7 mg/dL, p = 0.001). Multivariate regression analysis revealed that oral iron supplementation was significantly correlated to serum phosphate level (p = 0.023). There were no significant differences in all-cause mortality after dialysis initiation. CONCLUSION: This study showed that oral ferrous citrate or ferrous sulfate use during predialysis was associated with differences in serum phosphate level at dialysis initiation.

AB - AIM: Some reports claim that intravenous iron supplements reduce serum phosphate levels in patients with chronic kidney disease (CKD), including those on dialysis. However, whether divalent oral iron supplements influence serum phosphate levels in patients with CKD remains unclear; thus, this study aimed to address this topic. MATERIALS AND METHODS: The study database was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP), which is a multicenter, prospective, cohort study. Patients were classified into two groups: those who received iron orally (iron group, n = 255) from pre-dialysis to dialysis initiation and those who did not receive iron supplements (no-iron group, n = 1,261). Moreover, patients were classified into two groups (255 patients in each) by propensity score (PS) matching. We compared serum phosphate level at dialysis initiation and all-cause mortality. Multivariate regression analysis was used to extract factors contributing to serum phosphate level at dialysis initiation through a stepwise method. RESULTS: Serum phosphate levels at dialysis initiation were significantly lower in the iron group (all cohort, 6.0 ± 1.6 vs. 6.4 ± 1.9 mg/dL, p = 0.001; PS-matched cohort, 6.0 ± 1.6 vs. 6.5 ± 1.7 mg/dL, p = 0.001). Multivariate regression analysis revealed that oral iron supplementation was significantly correlated to serum phosphate level (p = 0.023). There were no significant differences in all-cause mortality after dialysis initiation. CONCLUSION: This study showed that oral ferrous citrate or ferrous sulfate use during predialysis was associated with differences in serum phosphate level at dialysis initiation.

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