The Role of Iron-Based Phosphate Binder in the Treatment of Hyperphosphatemia

Nephrol Nurs J. 2023 Mar-Apr;50(2):140-144.

Abstract

Hyperphosphatemia is a well-known complication of kidney disease. Phosphate binders are a mainstay treatment, but despite the existence of several phosphate binders, there is no one best approach to manage hyperphosphatemia. Phosphate binders are calcium-based, non-calcium- based, and others. While calcium-based phosphate binders are used frequently, they may cause hypercalcemia. Conversely, lanthanum carbonate and sevelamer were not linked to hypercalcemia but are costlier. The most recently developed class of phosphate binders is the ironbased ferric citrate and sucroferric oxyhydroxide. These have an important role in controlling phosphate levels due to their ability to lower the phosphate while concurrently providing iron sources. This review provides pharmacological profiles of different phosphate binders and their clinical usages, and further elaborates on their place in hyperphosphatemia management.

Keywords: ferric citrate; iron-based; phosphate binder; sucroferric oxyhydroxide.

Publication types

  • Review

MeSH terms

  • Calcium / therapeutic use
  • Humans
  • Hypercalcemia* / complications
  • Hypercalcemia* / drug therapy
  • Hyperphosphatemia* / drug therapy
  • Hyperphosphatemia* / etiology
  • Iron / therapeutic use
  • Phosphates / therapeutic use
  • Sevelamer / therapeutic use

Substances

  • Iron
  • Sevelamer
  • ferric phosphate
  • Phosphates
  • Calcium