Evidence map›Paper›PMID 30380116›Full record

Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2019

Effect of ferric citrate on serum phosphate and fibroblast growth factor 23 among patients with nondialysis-dependent chronic kidney disease: path analyses.

Geoffrey A Block, Pablo E Pergola, Steven Fishbane, Julian G Martins, Robin D LeWinter, Katrin Uhlig, John F Neylan, Glenn M Chertow

Open access · hybridAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Review
  7. Review
  8. Effects of ferric citrate and intravenous iron sucrose on markers of mineral, bone, and iron homeostasis in a rat model of CKD-MBD.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022
    Article
  9. Article
  10. Phosphate Is a Cardiovascular Toxin.Advances in experimental medicine and biology · 2022
    Review
  11. Article
  12. Regulation of FGF23: Beyond Bone.Current osteoporosis reports · 2021
    Review
  13. Iron Therapy in Chronic Kidney Disease: Days of Future Past.International journal of molecular sciences · 2021
    Review
  14. State-of-the-Art Management of Hyperphosphatemia in Patients With CKD: An NKF-KDOQI Controversies Perspective.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021
    Article
  15. Hyperphosphatemia and Cardiovascular Disease.Frontiers in cell and developmental biology · 2021
    Review
  16. Fibroblast Growth Factor-23 and a Vegetarian Diet.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2020
    Article
  17. Review
  18. Review
  19. Targeting Vascular Calcification in Chronic Kidney Disease.JACC. Basic to translational science · 2020
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Geoffrey A BlockDenver Nephrologists PC, Denver, CO, USA.
Pablo E PergolaRenal Associates PA, San Antonio, TX, USA.
Steven FishbaneHofstra North Shore-Long Island Jewish School of Medicine, Great Neck, NY, USA.
Julian G MartinsinScience Communications, Springer Healthcare, Paris, France.
Robin D LeWinterKeryx Biopharmaceuticals, Boston, MA, USA.
Katrin UhligKeryx Biopharmaceuticals, Boston, MA, USA.
John F NeylanKeryx Biopharmaceuticals, Boston, MA, USA.
Glenn M ChertowStanford University, Palo Alto, CA, USA.
Colorado Kidney Care · USPalo Alto University · USRenal Associates P. A. · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAmong patients with nondialysis-dependent chronic kidney disease (NDD-CKD) and iron-deficiency anemia (IDA), ferric citrate increases hemoglobin and iron parameters and reduces serum phosphate and fibroblast growth factor 23 (FGF23), a key phosphate-regulating hormone. We conducted post hoc analyses of a phase 3 trial to explore associations between iron replacement, serum phosphate changes and FGF23 regulation.

methodsWe employed multivariable regression and longitudinal mixed-effects models to identify and confirm, respectively, whether baseline demographic and laboratory variables were associated with ferric citrate-induced changes in serum phosphate or FGF23 concentrations. We employed path analyses to determine whether changes in FGF23 concentrations were mediated via changes in serum phosphate and/or transferrin saturation (TSAT).

resultsWe analyzed a total of 117 and 115 ferric citrate-treated and placebo-treated patients, respectively. At 16 weeks, ferric citrate significantly reduced serum phosphate versus placebo (P = 0.006) only among patients with elevated baseline serum phosphate (≥4.5 mg/dL) and did not reduce serum phosphate among patients with baseline serum phosphate within the population reference range. Ferric citrate reduced intact FGF23 and C-terminal FGF23 partially via changes in TSAT (for C-terminal FGF23) and serum phosphate (for intact FGF23) and partially via unknown/unmeasured mechanisms.

conclusionsFerric citrate reduced serum FGF23 concentrations (partially via effects on serum phosphate and iron balance) and did not reduce serum phosphate among patients with baseline serum phosphate concentrations within the population reference range.

Indexed as

AgedAnemia, Iron-DeficiencyBiomarkersDouble-Blind MethodEnzyme-Linked Immunosorbent AssayFemaleFerric CompoundsFibroblast Growth Factor-23Fibroblast Growth FactorsFollow-Up StudiesHumansMalePhosphatesRenal DialysisRenal Insufficiency, ChronicBiomarkersferric citrateFerric CompoundsFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsPhosphatesferric citrateFGF23iron-deficiency anemianondialysis-dependent chronic kidney diseaseserum phosphate

Identifiers

PMID30380116
PMCPMC6603396
OpenAlexW2898749986

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.