Kronik böbrek hastalarında ferrik karboksimaltoz tedavisinin serum fosfor düzeyine etkisi

Year 2021, , 266 - 272, 31.03.2021

Emel Isıktas Sayılar

https://doi.org/10.17826/cumj.794501

Abstract

Amaç: Çalışmamızda kronik böbrek hastalarında Ferrik karboksimaltoz (FKM) replasmanının başta fosfor olmak üzere mineral metabolizma parametreleri ve anemi profili üzerindeki etkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Eylül 2018 ve Mart 2020 tarihleri arasında kronik böbrek hastalığı nedeniyle takip edilen ve demir eksikliği anemisi nedeniyle FKM tedavisi verilmiş 59 hasta çalışmaya dahil edilmiştir. Tüm hastalara FKM tek doz 1000mg olarak verilmiş, tedavi öncesi ve tedavi sonrası 1. ay ve 3. ay laboratuvar tetkikleri değerlendirilmiştir.
Bulgular: Tedavi öncesi ortalama serum fosfor düzeyi 3.82±0.65 mg/dL, hemoglobin değeri 11.19±1.55 g/dL ve ferritin düzeyi 25.70 (11.90-54.70) µg/L bulunmuştur. FKM replasmanı sonrası 1. ayda 19 hastada (%32.2) hipofosfatemi gelişmiştir ve serum fosfor düzeyinde başlangıca göre ortalama %17.8 oranında düşüş izlenirken kalsiyum, PTH, 25(OH)D vitamini, kreatinin ve eGFR düzeylerinde anlamlı değişiklik olmamıştır. Hiçbir hastada FKM ilişkili yan etki gözlenmemiştir. Tedavi sonrası 3. ayda 25 hastada (%42.3) hemoglobin değeri ≥1 g/dL artış göstermiştir.
Sonuç: Diyalize girmeyen kronik böbrek hastalarında demir eksikliği anemisi tedavisinde FKM iyi tolere edilen ve hızlı etki gösteren bir parenteral tedavi seçeneğidir. Sıklıkla asemptomatik ve geçici olarak ortaya çıkan hipofosfatemi önemsiz ve tedavi kararını etkilemeyecek bir yan etki olarak kabul edilebilir.

Keywords

Kronik böbrek hastalığı, demir eksikliği anemisi, demir replasmanı, ferrik karboksi maltoz, hipofosfatemi

The impact of ferric carboxymaltose treatment on serum phosphorus levels in chronic kidney disease

Abstract

Purpose: This study aimed to investigate the effect of ferric carboxymaltose (FCM) replacement on mineral metabolism parameters, mainly the phosphorus, and the anemia profile in patients with chronic kidney disease (CKD).
Materials and Methods: A total of 59 patients with CKD who received FCM treatment for iron deficiency anemia were included in this study conducted between September 2018 and March 2020. All patients received single-dose 1000 mg FCM and post-treatment 1st month and 3rd month laboratory parameters were recorded.
Results: Pre-treatment mean±SD serum phosphorus levels were 3.82±0.65 mg/dL, hemoglobin levels were 11.19±1.55 g/dL and ferritin levels were 25.70 (11.90-54.70) µg/L. After 1-month FCM treatment, hypophosphatemia was noted in 19(32.2%) patients with decrease from baseline serum phosphorus levels by 17.8%, while no significant change occurred in PTH, 25(OH)D vitamin, creatinine and eGFR levels. None of patients developed adverse events related to FCM. In the 3rd month of treatment, hemoglobin levels were increased by ≥1 g/dL in 25(42.3%) patients.
Conclusion: In CKD patients not on dialysis, FCM seems to be a fast acting parenteral treatment alternative with favorable tolerance. Hypophosphatemia develops as an asymptomatic and transient side effect in most of cases with significant impact on treatment decision.

Keywords

Chronic kidney disease, iron deficiency anemia, iron replacement, ferric carboxymaltose, hypophosphatemia

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