Department of Health Science, The Graduate School, Jikei University School of Medicine, Tokyo, Japan.
Medical Affairs Department, Torii Pharmaceutical, Tokyo, Japan.
Ren Fail. 2024 Dec;46(2):2395449. doi: 10.1080/0886022X.2024.2395449. Epub 2024 Sep 4.
Although it has been established that patients with chronic kidney disease and iron deficiency, as indicated by a transferrin saturation of < 20%, are at increased risk of all-cause mortality and cardiovascular events, the optimal management of such patients has not yet been determined. In this post hoc subgroup analysis, we aimed to clarify the effect of ferric citrate hydrate on transferrin saturation in patients with chronic kidney disease and low transferrin saturation (< 20%) undergoing hemodialysis. To accomplish this, we extracted the relevant data on a subset of patients drawn from two previous studies: the ASTRIO study (A Study examining the contribution to Renal anemia treatment with ferric citrate hydrate, Iron-based Oral phosphate binder, UMIN000019176) and a post-marketing surveillance study. The subset of patients used for the present study were those with baseline transferrin saturation < 20%. We found that administration of ferric citrate hydrate increased transferrin saturation and maintained transferrin saturation at approximately 30%. However, because we did not have access to data on all-cause mortality or cardiovascular events, we could not ascertain whether the frequency of these outcomes was reduced in parallel with improvements in transferrin saturation. Further large studies are required.
虽然已经确定，转铁蛋白饱和度<20%的慢性肾脏病和缺铁患者发生全因死亡率和心血管事件的风险增加，但此类患者的最佳治疗方法尚未确定。在本次事后亚组分析中，我们旨在阐明柠檬酸铁治疗对正在接受血液透析的慢性肾脏病和低转铁蛋白饱和度（<20%）患者转铁蛋白饱和度的影响。为此，我们从两项先前的研究中提取了一部分患者的相关数据：ASTRIO 研究（一项研究，评估柠檬酸铁对肾性贫血治疗的贡献，基于铁的口服磷结合剂，UMIN000019176）和上市后监测研究。本研究使用的患者亚组为基线转铁蛋白饱和度<20%的患者。我们发现，柠檬酸铁的给药增加了转铁蛋白饱和度，并将转铁蛋白饱和度维持在约 30%。然而，由于我们没有获得全因死亡率或心血管事件的数据，因此无法确定这些结局的发生率是否与转铁蛋白饱和度的改善平行降低。需要进一步开展大型研究。
