Hypophosphataemia, fibroblast growth factor 23 and third-generation intravenous iron compounds: a narrative review

Kassianides, Xenophon; Bhandari, Sunil

doi:10.7573/dic.2020-11-3

Cited by 27 publications

(29 citation statements)

References 127 publications

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“…The 6H syndrome (high FGF-23, hypophosphatemia, hyperphosphaturia, hypovitaminosis D, hypocalcemia, and secondary hyperparathyroidism) seen with various IV iron formulations but most prominent with FCM is thought to occur due to impaired cleavage (inactivation) of the phosphatonin FGF-23. 57,58 Longer term complications of hypophosphatemic osteomalacia and J o u r n a l P r e -p r o o f 13 fractures have also been described (Figure 2). 59 Clinicians will need to weigh the relative risks, costs, and availability of the various intravenous iron formulations when selecting therapy (Table 3).…”

Section: H Syndromementioning

confidence: 99%

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Recent and Emerging Therapies for Iron Deficiency in Anemia of CKD: A Review

Bazeley

Wish

2022

American Journal of Kidney Diseases

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Section: H Syndromementioning

confidence: 99%

“…J o u r n a l P r e -p r o o f principally with ferric carboxymaltose to date. Based on information from Kassianides et al, 57 Blumenstein et al, 36 and Glaspy et al…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Recent and Emerging Therapies for Iron Deficiency in Anemia of CKD: A Review

Bazeley

Wish

2022

American Journal of Kidney Diseases

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“…Se define como niveles séricos de fosfato menores a 2,5 mg/dl (0,80mmol/L). Se clasifica en hipofosfatemia leve cuando esta entre 1,8-2,5mg/dl (0,6-0,8mmol/L), moderada entre 1,0-1,7mg/dl (0,4-0,5mmol/L) o severa cuando es menor a 1,0mg/dl (0,4mmol/L) (33,36).…”

Section: Hipofosfatemiaunclassified

Trastornos Electrolíticos

Vásquez

Miguitama

2022

Tesla rev. cient.

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Los líquidos y los electrolitos son constituyentes indispensables de cuyo equilibrio depende el normal funcionamiento del organismo, sus alteraciones tanto en exceso como en déficit repercuten negativamente en el estado de salud, su reconocimiento temprano, su oportuna corrección y la reevaluación frecuente son puntos clave para el retorno a la salud. En el siguiente capítulo se revisará las principales alteraciones de los líquidos y electrolitos.

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“…Hypophosphatemia was transient; however, case reports described chronic hypophosphatemia with osteomalacia in patients with chronic anemia requiring repeated IV iron infusion [ 118 ]. The proposed mechanism is FCM blocking the cleavage of intact FGF-23 (iFGF-23) to inactive cleaved FGF-23 and subsequently the increased iFGF-23 level leads to phosphaturia [ 119 ]. Additional supportive therapies causing hypophosphatemia are listed in Table 2 .…”

Section: Etiology Of Hypophosphatemia In Cancermentioning

confidence: 99%

Hypophosphatemia in cancer patients

Adhikari

Mamlouk

Rondon‐Berrios

et al. 2021

Clinical Kidney Journal

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Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type, and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophosphatemia can impair tissue oxygenation, cause hemolysis, leukocyte and platelet dysfunction, encephalopathy, seizures, arrhythmias, cardiomyopathy, rhabdomyolysis, and coma. Multiple studies have demonstrated that hypophosphatemia is an adverse prognostic marker in inpatients with increased in-hospital stay, mortality, and postoperative complications. The phosphate level is homeostatically regulated and maintained in a narrow range by 3 main hormones: PTH, FGF-23, and 1,25 (OH)2 Vitamin D3. Together, these hormones regulate how the intestine, kidneys, and bones traffic phosphorus. Several hematological malignancies and cancer therapies are associated with proximal tubular dysfunction (Fanconi syndrome), resulting in phosphaturia. Caution should be taken with parenteral administration of phosphate salts because secondary complications can develop principally due to hypocalcemia. The general approach to hypophosphatemia should target the underlying cause. Early recognition and prevention are essential, and the approach to hypophosphatemia in the cancer patient because of the nuances and complexity should be multidisciplinary.

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Hypophosphataemia, fibroblast growth factor 23 and third-generation intravenous iron compounds: a narrative review

Cited by 27 publications

References 127 publications

Recent and Emerging Therapies for Iron Deficiency in Anemia of CKD: A Review

Recent and Emerging Therapies for Iron Deficiency in Anemia of CKD: A Review

Trastornos Electrolíticos

Hypophosphatemia in cancer patients

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