Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2019
Iron Infusion and Induced Hypophosphatemia: The Role of Fibroblast Growth Factor-23.
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Coppolino Giuseppe, Nicotera Ramona, Cernaro Valeria, Calimeri Sebastiano, Leonardi Giuseppe, Cosentino Sonia, Comi Alessandro, Donato Cinzia, Lucia Citraro Maria, Provenzano Michele, Michael Ashour, Andreucci Michele
Аннотация
The mechanism of action of fibroblast growth factor-23 (FGF23) is becoming increasingly clearer as a result of studies that have defined its structure and pleiotropic effects. Furthermore, data are emerging on the effects exerted on this hormone by iron administration. Ten main iron formulations are recognized (with clear differences in composition and possible reactions of intolerance and anaphylaxis), which are indicated for iron deficiency anemia, including nephropathic subjects, as suggested by medical guidelines. With some types of iron formulation (especially iron carboxymaltose) a particular side effect has been observed: hypophosphatemia, mediated by FGF23. This review aims to draw attention to this correlation and the contradiction represented by the presence of both positive and negative modulation by FGF23, with the effects induced by its increase even after long-term treatment with iron formulation. However, more evidence is needed to understand the reasons for this differential stimulation.