Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease
Introduction It has been observed that intravenous iron administration may suppress endogenous production of erythropoietin (EPO). We postulate that this effect may be mediated by increased FGF-23 secretion.Aim of the study To evaluate the short-term effect of intravenous iron sucrose administration...
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2164305 |
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| author | Katarzyna Muras-Szwedziak Ewa Pawłowicz-Szlarska Michał Nowicki |
| author_facet | Katarzyna Muras-Szwedziak Ewa Pawłowicz-Szlarska Michał Nowicki |
| author_sort | Katarzyna Muras-Szwedziak |
| collection | DOAJ |
| description | Introduction It has been observed that intravenous iron administration may suppress endogenous production of erythropoietin (EPO). We postulate that this effect may be mediated by increased FGF-23 secretion.Aim of the study To evaluate the short-term effect of intravenous iron sucrose administration on endogenous EPO secretion in patients with chronic kidney disease (CKD).Materials and methods The cohort comprised 35 nondialysis patients with CKD stages 3–5. All received 100 mg of intravenous iron (III)-hydroxide sucrose complex daily for five consecutive days. Plasma EPO, iFGF-23, cFGF-23, PTH, bone alkaline phosphatase (BAP), phosphorus (PO4), calcium (Ca), and high-sensitive C-reactive protein (CRP) were measured before, and two hours after, the first and third iron infusions, and after completing iron therapy.Results EPO concentration at the end of iron treatment was significantly lower than two hours after the first iron infusion (p = 0.0003) and before the third dose (p = 0.0006) (12.6 [10.2, 41.4] mIU/mL. vs. 30.9 [15.9, 54.2] mIU/mL and 33.4 [15.4, 56.7] mIU/mL, respectively). Conversely, plasma iFGF-23 was significantly higher before the third dose (61.1 [18.6, 420.1 4] pg/mL; p = 0.025) and after the course of treatment (92.1 [28.4, 878.1] pg/mL; p = 0.004) compared to pretreatment value (48.4 [16.2, 420] pg/mL). cFGF-23 concentration was significantly lower than baseline after the first iron dose (491.8 [257.7, 1086.3] vs. 339.2 [75.4, 951.2] RU/mL; p = 0.005) and after treatment (398.7 [90.4, 1022.3] RU/mL; p = 0.025). No significant linear correlation was found between changes in plasma EPO and FGF-23.Conclusions Although intravenous iron therapy causes parallel increase of FGF-23 and supression of endogenous EPO, these two effects seem to be independent. |
| format | Article |
| id | doaj-art-80b567cfe5034450aa70ee9aa2d3d86c |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
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| series | Renal Failure |
| spelling | doaj-art-80b567cfe5034450aa70ee9aa2d3d86c2025-08-20T03:48:57ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2022.2164305Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney diseaseKatarzyna Muras-Szwedziak0Ewa Pawłowicz-Szlarska1Michał Nowicki2Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, PolandDepartment of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, PolandDepartment of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, PolandIntroduction It has been observed that intravenous iron administration may suppress endogenous production of erythropoietin (EPO). We postulate that this effect may be mediated by increased FGF-23 secretion.Aim of the study To evaluate the short-term effect of intravenous iron sucrose administration on endogenous EPO secretion in patients with chronic kidney disease (CKD).Materials and methods The cohort comprised 35 nondialysis patients with CKD stages 3–5. All received 100 mg of intravenous iron (III)-hydroxide sucrose complex daily for five consecutive days. Plasma EPO, iFGF-23, cFGF-23, PTH, bone alkaline phosphatase (BAP), phosphorus (PO4), calcium (Ca), and high-sensitive C-reactive protein (CRP) were measured before, and two hours after, the first and third iron infusions, and after completing iron therapy.Results EPO concentration at the end of iron treatment was significantly lower than two hours after the first iron infusion (p = 0.0003) and before the third dose (p = 0.0006) (12.6 [10.2, 41.4] mIU/mL. vs. 30.9 [15.9, 54.2] mIU/mL and 33.4 [15.4, 56.7] mIU/mL, respectively). Conversely, plasma iFGF-23 was significantly higher before the third dose (61.1 [18.6, 420.1 4] pg/mL; p = 0.025) and after the course of treatment (92.1 [28.4, 878.1] pg/mL; p = 0.004) compared to pretreatment value (48.4 [16.2, 420] pg/mL). cFGF-23 concentration was significantly lower than baseline after the first iron dose (491.8 [257.7, 1086.3] vs. 339.2 [75.4, 951.2] RU/mL; p = 0.005) and after treatment (398.7 [90.4, 1022.3] RU/mL; p = 0.025). No significant linear correlation was found between changes in plasma EPO and FGF-23.Conclusions Although intravenous iron therapy causes parallel increase of FGF-23 and supression of endogenous EPO, these two effects seem to be independent.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2164305Anemiaironerythropoietinfibroblast growth factor-23inflammation |
| spellingShingle | Katarzyna Muras-Szwedziak Ewa Pawłowicz-Szlarska Michał Nowicki Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease Renal Failure Anemia iron erythropoietin fibroblast growth factor-23 inflammation |
| title | Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease |
| title_full | Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease |
| title_fullStr | Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease |
| title_full_unstemmed | Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease |
| title_short | Effect of intravenous iron on endogenous erythropoietin and FGF-23 secretion in patients with chronic kidney disease |
| title_sort | effect of intravenous iron on endogenous erythropoietin and fgf 23 secretion in patients with chronic kidney disease |
| topic | Anemia iron erythropoietin fibroblast growth factor-23 inflammation |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2164305 |
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