Aslam Nabeel, Govani Maulik, Basdeo Luke M, Wadei Hani M
Clin Nephrol. 2020 May;93(5):262-266. doi: 10.5414/CN109738.
Ferric citrate (FC), a novel oral phosphate binder, is approved by the U.S. Food and Drug Administration (FDA) for the treatment of hyperphosphatemia in end-stage renal disease (ESRD) patients receiving dialysis. FC binds to dietary phosphate in the gastrointestinal (GI) tract producing ferric phosphate that is excreted in feces. However, a small quantity of iron is systemically absorbed. There are limited data regarding the safety of the maximum approved dose of FC among peritoneal dialysis (PD) patients. We present a series of 3 PD patients who developed iron overload while receiving FC for management of hyperphosphatemia. These cases highlight the importance of close monitoring of iron studies and question whether a lower maximum dose of FC should be recommended in PD patients. Further studies are needed to assess the safety of the maximum approved dose of FC among PD patients.
柠檬酸铁（FC）是一种新型口服磷结合剂，已获美国食品药品监督管理局（FDA）批准，用于治疗接受透析的终末期肾病（ESRD）患者的高磷血症。FC在胃肠道（GI）中与膳食磷结合，生成磷酸铁，随粪便排出。然而，有少量铁被全身吸收。关于腹膜透析（PD）患者中FC最大批准剂量的安全性数据有限。我们报告了3例接受FC治疗高磷血症时发生铁过载的PD患者。这些病例凸显了密切监测铁相关指标的重要性，并引发了对于是否应在PD患者中推荐更低的FC最大剂量的质疑。需要进一步研究来评估PD患者中FC最大批准剂量的安全性。
