Effects of the administration of ferric citrate hydrate on inflammatory and oxidative stress markers as well as improvements in anemia treatment

Abstract

This prospective 12-week study aimed to evaluate the changes in the levels of inflammatory and oxidative stress markers after the administration of ferric citrate hydrate (FCH) and to determine whether the serum hepcidin-25 level could serve as a prognostic indicator during the treatment of anemia with FCH. The serum levels of inorganic phosphorus, hemoglobin (Hb), iron, erythropoiesis-stimulating agents (ESA), inflammatory and oxidative stress markers, and serum hepcidin-25 together with the erythropoietin resistance index (ERI) were studied in both the FCH treatment group (1,500 mg/day FCH) and control group (who were administered a phosphate binder other than FCH). The patients that exhibited changes of <10% in their serum hepcidin-25 levels were designated the “invariant group”, whereas those that exhibited changes of >10% in their serum hepcidin-25 levels were designated the “gain group”. In the FCH group, significant increases in the serum ferritin level and significant reductions in the ERI and the serum ESA level were observed after the administration of FCH. There were no significant changes in inflammatory or oxidative stress markers in either group. The invariant group exhibited significantly higher Hb levels than the gain group (2.2±0.4 vs. −0.6±1.4 g/dL, respectively ; p=0.0105). Therefore, the serum hepcidin-25 level could be a novel prognostic marker of the increase in the Hb level induced by the administration of FCH.