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Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial

Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was co...

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Autores principales: Tomosugi, Naohisa, Koshino, Yoshitaka, Ogawa, Chie, Maeda, Kunimi, Shimada, Noriaki, Tomita, Kimio, Daimon, Shoichiro, Shikano, Tsutomu, Ryu, Kazuyuki, Takatani, Toru, Sakamoto, Kazuya, Ueyama, Satonori, Nagasaku, Daisuke, Nakamura, Masato, Ra, Shibun, Nishimura, Masataka, Takagi, Chieko, Ishii, Yoji, Kudo, Noritoshi, Takechi, Shinsuke, Ishizu, Takashi, Yanagawa, Takamoto, Fukuda, Masamichi, Nitta, Yutaka, Yamaoka, Takayuki, Saito, Taku, Imayoshi, Suzuko, Omata, Momoyo, Oshima, Joji, Onozaki, Akira, Ichihashi, Hiroaki, Matsushima, Yasuhisa, Takae, Hisahito, Nakazawa, Ryoichi, Ikeda, Koichi, Tsuboi, Masato, Konishi, Keiko, Kato, Shouzaburo, Ooura, Maki, Koyama, Masaki, Naganuma, Tsukasa, Ogi, Makoto, Katayama, Shigeyuki, Okumura, Toshiaki, Kameda, Shigemi, Shirai, Sayuri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531220/
https://www.ncbi.nlm.nih.gov/pubmed/37762085
http://dx.doi.org/10.3390/ijms241813779
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author Tomosugi, Naohisa
Koshino, Yoshitaka
Ogawa, Chie
Maeda, Kunimi
Shimada, Noriaki
Tomita, Kimio
Daimon, Shoichiro
Shikano, Tsutomu
Ryu, Kazuyuki
Takatani, Toru
Sakamoto, Kazuya
Ueyama, Satonori
Nagasaku, Daisuke
Nakamura, Masato
Ra, Shibun
Nishimura, Masataka
Takagi, Chieko
Ishii, Yoji
Kudo, Noritoshi
Takechi, Shinsuke
Ishizu, Takashi
Yanagawa, Takamoto
Fukuda, Masamichi
Nitta, Yutaka
Yamaoka, Takayuki
Saito, Taku
Imayoshi, Suzuko
Omata, Momoyo
Oshima, Joji
Onozaki, Akira
Ichihashi, Hiroaki
Matsushima, Yasuhisa
Takae, Hisahito
Nakazawa, Ryoichi
Ikeda, Koichi
Tsuboi, Masato
Konishi, Keiko
Kato, Shouzaburo
Ooura, Maki
Koyama, Masaki
Naganuma, Tsukasa
Ogi, Makoto
Katayama, Shigeyuki
Okumura, Toshiaki
Kameda, Shigemi
Shirai, Sayuri
author_facet Tomosugi, Naohisa
Koshino, Yoshitaka
Ogawa, Chie
Maeda, Kunimi
Shimada, Noriaki
Tomita, Kimio
Daimon, Shoichiro
Shikano, Tsutomu
Ryu, Kazuyuki
Takatani, Toru
Sakamoto, Kazuya
Ueyama, Satonori
Nagasaku, Daisuke
Nakamura, Masato
Ra, Shibun
Nishimura, Masataka
Takagi, Chieko
Ishii, Yoji
Kudo, Noritoshi
Takechi, Shinsuke
Ishizu, Takashi
Yanagawa, Takamoto
Fukuda, Masamichi
Nitta, Yutaka
Yamaoka, Takayuki
Saito, Taku
Imayoshi, Suzuko
Omata, Momoyo
Oshima, Joji
Onozaki, Akira
Ichihashi, Hiroaki
Matsushima, Yasuhisa
Takae, Hisahito
Nakazawa, Ryoichi
Ikeda, Koichi
Tsuboi, Masato
Konishi, Keiko
Kato, Shouzaburo
Ooura, Maki
Koyama, Masaki
Naganuma, Tsukasa
Ogi, Makoto
Katayama, Shigeyuki
Okumura, Toshiaki
Kameda, Shigemi
Shirai, Sayuri
author_sort Tomosugi, Naohisa
collection PubMed
description Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body’s iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (−0.459, −0.643 to −0.276, p = 0.000; −0.648, −1.099 to −0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (−1.392, −1.749 to −1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.
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spelling pubmed-105312202023-09-28 Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial Tomosugi, Naohisa Koshino, Yoshitaka Ogawa, Chie Maeda, Kunimi Shimada, Noriaki Tomita, Kimio Daimon, Shoichiro Shikano, Tsutomu Ryu, Kazuyuki Takatani, Toru Sakamoto, Kazuya Ueyama, Satonori Nagasaku, Daisuke Nakamura, Masato Ra, Shibun Nishimura, Masataka Takagi, Chieko Ishii, Yoji Kudo, Noritoshi Takechi, Shinsuke Ishizu, Takashi Yanagawa, Takamoto Fukuda, Masamichi Nitta, Yutaka Yamaoka, Takayuki Saito, Taku Imayoshi, Suzuko Omata, Momoyo Oshima, Joji Onozaki, Akira Ichihashi, Hiroaki Matsushima, Yasuhisa Takae, Hisahito Nakazawa, Ryoichi Ikeda, Koichi Tsuboi, Masato Konishi, Keiko Kato, Shouzaburo Ooura, Maki Koyama, Masaki Naganuma, Tsukasa Ogi, Makoto Katayama, Shigeyuki Okumura, Toshiaki Kameda, Shigemi Shirai, Sayuri Int J Mol Sci Article Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body’s iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (−0.459, −0.643 to −0.276, p = 0.000; −0.648, −1.099 to −0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (−1.392, −1.749 to −1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake. MDPI 2023-09-07 /pmc/articles/PMC10531220/ /pubmed/37762085 http://dx.doi.org/10.3390/ijms241813779 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tomosugi, Naohisa
Koshino, Yoshitaka
Ogawa, Chie
Maeda, Kunimi
Shimada, Noriaki
Tomita, Kimio
Daimon, Shoichiro
Shikano, Tsutomu
Ryu, Kazuyuki
Takatani, Toru
Sakamoto, Kazuya
Ueyama, Satonori
Nagasaku, Daisuke
Nakamura, Masato
Ra, Shibun
Nishimura, Masataka
Takagi, Chieko
Ishii, Yoji
Kudo, Noritoshi
Takechi, Shinsuke
Ishizu, Takashi
Yanagawa, Takamoto
Fukuda, Masamichi
Nitta, Yutaka
Yamaoka, Takayuki
Saito, Taku
Imayoshi, Suzuko
Omata, Momoyo
Oshima, Joji
Onozaki, Akira
Ichihashi, Hiroaki
Matsushima, Yasuhisa
Takae, Hisahito
Nakazawa, Ryoichi
Ikeda, Koichi
Tsuboi, Masato
Konishi, Keiko
Kato, Shouzaburo
Ooura, Maki
Koyama, Masaki
Naganuma, Tsukasa
Ogi, Makoto
Katayama, Shigeyuki
Okumura, Toshiaki
Kameda, Shigemi
Shirai, Sayuri
Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title_full Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title_fullStr Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title_full_unstemmed Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title_short Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial
title_sort oral iron absorption of ferric citrate hydrate and hepcidin-25 in hemodialysis patients: a prospective, multicenter, observational riona-oral iron absorption trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531220/
https://www.ncbi.nlm.nih.gov/pubmed/37762085
http://dx.doi.org/10.3390/ijms241813779
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