Clinical experience with the use of ferric citrate as a phosphate binder in pediatric dialysis patients.
Clinical experience with the use of ferric citrate as a phosphate binder in pediatric dialysis patients.
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DOI：
10.1007/s00467-018-3999-y
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Salusky IB
中科院分区：
文献类型：
--
作者：
Hanudel MR;Laster M;Ramos G;Gales B;Salusky IB
柠檬酸铁是一种铁基磷酸盐结合剂，已被证明可改善成人慢性肾病患者的高磷酸盐血症和铁缺乏症，但尚未描述其在儿科透析人群中的应用。这是一项对2015年至2017年期间接受柠檬酸铁作为磷结合剂的11例儿童透析患者的回顾性分析。使用Wilcoxon符号秩检验比较柠檬酸铁开始治疗前后的时间平均实验室值。该队列的中位年龄为13岁（范围4 - 17岁）。5名患者接受血液透析，6名患者接受腹膜透析。枸橼酸铁治疗的中位持续时间为214天（范围39 - 654天），枸橼酸铁的中位时间平均剂量为3.5片/天（范围1.5 - 8.4片/天）。与柠檬酸铁治疗前相比，柠檬酸铁治疗与血清磷酸盐降低相关（6.5 mg/dl至5.2 mg/dl，p=0.014），血清磷酸盐年龄相关标准差评分（SDS）降低（2.3至0.9，p=0.019），转铁蛋白饱和度增加（26%至34%，p=0.049），铁蛋白增加（107 ng/ml至230 ng/ml，p=0.074），血细胞比容维持不变。在儿科透析患者中，柠檬酸铁可能能够同时降低磷酸盐水平并治疗铁缺乏症。然而，需要更大规模的研究来进一步评估儿童慢性肾脏疾病人群的安全性和有效性。
Ferric citrate, an iron-based phosphate binder, has been shown to improve both hyperphosphatemia and iron deficiency in adult chronic kidney disease patients, but its use in the pediatric dialysis population has not been described. This is a retrospective analysis of 11 unselected pediatric dialysis patients who received ferric citrate as a phosphate binder between 2015 and 2017. Time-averaged laboratory values were compared pre- and post-ferric citrate initiation using the Wilcoxon signed-rank test. The median age of this cohort was 13 years old (range 4 – 17 years old). Five patients were on hemodialysis, and six patients were on peritoneal dialysis. The median duration of ferric citrate therapy was 214 days (range 39 – 654 days), with a median time-averaged ferric citrate dose of 3.5 tablets per day (range 1.5 – 8.4 tablets per day). Compared to the pre-ferric citrate period, ferric citrate treatment was associated with decreased serum phosphate (6.5 mg/dl to 5.2 mg/dl, p=0.014), decreased serum phosphate age-related standard deviation score (SDS) (2.3 to 0.9, p=0.019), increased transferrin saturation (26% to 34%, p=0.049), increased ferritin (107 ng/ml to 230 ng/ml, p=0.074), and maintenance of hematocrit. In pediatric dialysis patients, ferric citrate may be able to concurrently lower phosphate levels and treat iron deficiency. However, larger studies are needed to further evaluate safety and efficacy in the pediatric chronic kidney disease population.
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DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gutiérrez OM;Mannstadt M;Isakova T;Rauh-Hain JA;Tamez H;Shah A;Smith K;Lee H;Thadhani R;Jüppner H;Wolf M
通讯作者：
Wolf M
DOI：
10.2215/cjn.02110217
发表时间：
2018-01-06
影响因子：
9.8
作者：
Mitsnefes, Mark M.;Betoko, Aisha;Portale, Anthony A.
通讯作者：
Portale, Anthony A.
DOI：
10.1038/ki.2009.188
发表时间：
2009-08-01
期刊：
Kidney international. Supplement
影响因子：
--
作者：
通讯作者：
--
影响因子：
13.6
作者：
Kestenbaum, B;Sampson, JN;Andress, DL
通讯作者：
Andress, DL
影响因子：
13.6
作者：
Lewis, Julia B.;Sika, Mohammed;Dwyer, Jamie P.
通讯作者：
Dwyer, Jamie P.