Using iron-based phosphate binders in phosphate reduction and anemia improvement in patients receiving dialysis: a meta-analysis of randomized controlled trials
| Autor: | Xueling Liao, Chao Xue, Jihong Ou, Wei Li, Yan Zhu, Jinlan Rao |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Sucrose
medicine.medical_specialty Anemia Iron Urology medicine.medical_treatment Fermagate Carbonates 030232 urology & nephrology 030204 cardiovascular system & hematology Placebo Ferric Compounds Gastroenterology law.invention 03 medical and health sciences Hyperphosphatemia 0302 clinical medicine Randomized controlled trial Renal Dialysis law Internal medicine medicine Humans Magnesium Dialysis Randomized Controlled Trials as Topic business.industry Transferrin saturation Starch medicine.disease Drug Combinations Treatment Outcome Nephrology Hemoglobin business |
| Zdroj: | International Urology and Nephrology. 53:1899-1909 |
| ISSN: | 1573-2584 0301-1623 |
| DOI: | 10.1007/s11255-021-02820-y |
| Popis: | A study was conducted to determine whether iron-based phosphate binders (IBPBs) need to be preferred for hyperphosphatemia and anemia management in patients on dialysis. For this meta-analysis, we searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials that evaluated the efficacy and safety of IBPBs in decreasing phosphate and correcting anemia in dialysis patients. Nineteen trials comprising 4719 participants were included. Compared with placebo, serum phosphate decreased significantly after treatment with ferric citrate (FC), fermagate (one study), and SBR759 (one study). Hemoglobin increased significantly after treatment with FC and sucroferric oxyhydroxide (PA21). In addition, FC and PA21 reduced serum intact parathyroid hormone (iPTH) and increased ferritin and transferrin saturation, but SBR759 did not. Compared with active treatment, the non-inferiority of IBPBs in reducing serum phosphate and iPTH was demonstrated. FC significantly improved serum hemoglobin and iron-related parameters and decreased the use of intravenous iron and erythropoiesis-stimulating agent, whereas PA21 did not increase serum hemoglobin level. The incidences of infection and hospitalization were similar between the two groups, with FC having a higher risk of diarrhea than the placebo and active treatments. FC was associated with the control of hyperphosphatemia and the improvement of anemia. However, PA21 did not show superiority for alleviating anemia compared with the active treatment. Other IBPBs, such as fermagate and SBR759, remained poorly understood due to the limited number of studies. Further trials are required to assess the effect of IBPBs on the risk of cardiovascular events and all-cause mortality. |
| Databáze: | OpenAIRE |
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