P0860INTRAVENOUS IRON ADMINISTRATION SUPPRESSES ENDOGENOUS ERYTHROPOIETIN SECRETION IN PATIENTS WITH CHRONIC KIDNEY DISEASE. (6th June 2020)

• Record Type: Journal Article
• Authors: Muras-Szwedziak, Katarzyna; Pawlowicz, Ewa; Nowicki, Michal
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa142.P0860
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Iron therapy may induce inflammatory response that may indirectly affect endogenous erythropoietin (EPO) production. We postulated that increased secretion of FGF-23 may provide a link between intravenous iron administration and suppression of endogenous EPO secretion. Evaluation of a short-term effect of intravenous iron sucrose administration on the secretion of endogenous EPO in patients with chronic kidney disease (CKD). Method: 35 non-dialysed patients with G3b-5 CKD were included. All patients received 100 mg of intravenous iron infusion (iron (III)-hydroxide sucrose complex) daily for 5 days. Plasma concentration of EPO, iFGF-23, cFGF-23, PTH, bone alkaline phosphatase (BAP), phosphorus (PO4) and calcium (Ca) were measured before and two hours after the first and third iron infusion and at the end of iron therapy. Results: EPO concentration at the end of iron treatment was significantly lower compared to 2 h after the first iron infusion (p<0.001) and before the third dose (p<0.001) (12.6 [31.2] mIU/mL, 30.9 [38.3] mIU/mL, 33.4 [41.3] mIU/mL and, respectively). Conversely, serum iFGF-23 increased significantly after the third dose (61.1 [401.5] pg/mL; p<0.05) and after the treatment (92.1 [849.7] pg/mL; p<0.01) compared to pre-treatment value (48.4 [403.8] pg/mL). cFGF-23 concentration decreased significantly after the first dose of iron (491.8 [828.6] vs. 339.2 [875.8] RU/mL; p<0.01) and after the completion of the therapy (398.7 [931.9]) vs. baseline (p<0.05). There was no linear correlation between EPO and FGF-23. Conclusion: Intravenous iron therapy increases the secretion of FGF-23 and supresses endogenous EPO production but these two effects do not seem to be related.