Phosphate Binder, Ferric Citrate, Attenuates Anemia, Renal Dysfunction, Oxidative Stress, Inflammation, and Fibrosis in 5/6 Nephrectomized CKD Rats

Renoprotective effects of ferric citrate in a mouse model of chronic kidney disease

“…Our results are consistent with those reported by Francis et al, where Col4α3 knockout mice were treated with a 5% FC diet 27 . Improved kidney function and decreased expression of pro-fibrotic molecules was also observed in a study of 5/6 nephrectomy CKD rats treated with a 4% FC diet 28 .…”

“…How FC treatment may affect renal parameters, including kidney disease progression, in patients with CKD is unknown. In the present study, we treated Col4α3 knockout mice (a murine model of progressive CKD) with a diet supplemented with 1% FC, a lower dose than has been previously assessed in rodent CKD models 27 , 28 . Compared to untreated Col4α3 knockout mice, the FC-treated mice had decreased serum phosphate concentrations, increased serum iron, dramatically reduced circulating FGF23 levels, decreased markers of systemic and kidney inflammation, improved kidney function, and decreased kidney fibrosis (as evidenced by decreased collagen type I accumulation in the kidney 29 ).…”

Renoprotective effects of sucroferric oxyhydroxide in a rat model of chronic renal failure

“…A beneficial renal effect was also reported with ferric citrate in this rat model. Remnant kidney rats treated with ferric citrate had lower serum creatinine and blood urea nitrogen levels, higher creatinine clearance and haemoglobin levels, as well as higher serum iron levels, as compared with vehicle-treated animals [ 23 ]. Furthermore, ferric citrate–treated rats showed less inflammation, oxidative stress and fibrosis and higher iron levels in the remnant kidney, less cardiac hypertrophy and fibrosis and a more beneficial gut microbiome compared with vehicle-treated rats [ 23–25 ].…”

“…Remnant kidney rats treated with ferric citrate had lower serum creatinine and blood urea nitrogen levels, higher creatinine clearance and haemoglobin levels, as well as higher serum iron levels, as compared with vehicle-treated animals [ 23 ]. Furthermore, ferric citrate–treated rats showed less inflammation, oxidative stress and fibrosis and higher iron levels in the remnant kidney, less cardiac hypertrophy and fibrosis and a more beneficial gut microbiome compared with vehicle-treated rats [ 23–25 ]. This, together with our current findings, using a model with different renal disease characteristics, is of particular interest, as the potential protective effect of iron-based phosphate binders on the kidneys of patients with impaired renal function but not yet on dialysis needs to be investigated.…”

Transforming the frail and elderly patient into an Iron Man: how to attenuate arterial calcification and improve cardiovascular outcomes in chronic kidney disease

“…In vivo studies demonstrate that administrating ferric citrate to treat hyperphosphatemia has a protective action against fibrosis and ultimately renal dysfunction. Interestingly, the beneficial effect of ferric citrate on kidney function results from an attenuation of oxidative stress and inflammation and the lowering of fibroblast growth factor 23 (FGF23) levels [3]. Moreover, in an in vivo model of progressive chronic kidney disease, ferric citrate significantly reduced FGF23 levels, preserved renal function and improved cardiac function [4].…”