The effects of ferric citrate, a new phosphate binder, on renal anemia, iron metabolism, and medical care costs among hemodialysis patients

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  • リン吸着薬の変更による鉄代謝と貧血の改善および医療経済学的効果
  • リン キュウチャクヤク ノ ヘンコウ ニ ヨル テツ タイシャ ト ヒンケツ ノ カイゼン オヨビ イリョウ ケイザイガクテキ コウカ

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<p>Ferric citrate (FC) is a new iron-containing phosphate binder, which has the potential to ameliorate anemia via iron supplementation. In this study, existing phosphate binders were replaced or used in combination with FC when treating hemodialysis patients with hyperphosphatemia or suspected iron deficiency. Then, the resultant changes in chronic kidney disease (CKD)-mineral and bone disorder (MBD)-related data (albumin-adjusted calcium, phosphate, alkaline phosphatase, and intact-parathyroid hormone levels), anemia (hemoglobin levels), iron metabolism (Fe, transferrin saturation, and ferritin levels), and total drug costs (oral medicines and injected drugs) were investigated. Twenty-four hemodialysis patients who exhibited suspected iron deficiency or gastrointestinal problems after treatment with other phosphate binders at our outpatient clinic were chosen. While no significant changes in their CKD-MBD-related laboratory data were detected after the FC treatment, significant improvements in anemia and iron metabolism-related laboratory data were seen at all observation points. Monthly oral medicine usage increased significantly after additional FC treatment. On the other hand, injected drug and total drug costs decreased significantly due to reduced use or the discontinuation of erythropoiesis-stimulating agents. The average reduction in monthly total drug costs was approximately 15,000 yen. The use of FC as a phosphate binder significantly ameliorated anemia and reduced medical costs.</p>

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