Background: Malnutrition is a major negative prognostic factor in dialysis patients. Simple and reliable estimations of nutritional status may therefore prove of particular value in the follow-up of these patients.

At baseline, the mean KDQOL 36 score was 90.4 with domains of health (KDQOL-H), kidney disease (KDQOL-K) and effect of kidney disease on life (KDQOL-E) scoring 31.5, 41.0 and 17.9 respectively. After 90 days of oral Ferric Citrate, the total KDQOL score decreased to 85.9, KDQOL-H decreased to 30.3, KDQOL-K decreased to 39.3 and KDOL-E decreased to 16.3. Adverse events were infrequent with diarrhea being the most common. 1 patient withdrew before starting drug and another withdrew after 1 month on drug due to constipation. Conclusions: Ferric citrate is a phosphate binder that can increase iron stores in ESRD patients that have high Ferritin and low TSAT which improves KDQOL 36 scores in these patients. Larger and more robust clinical trials are needed to confirm these findings. ClinicalTrials.gov Identifier: NCT03055598