Relationship Between Iron-Based Oral Phosphate Binders and Erythropoiesis in Peritoneal Dialysis Patients

Iron-based phosphate binders (IBPBs) are used for the treatment of hyperphosphatemia. However, the erythropoiesis effects of IBPB treatment in peritoneal dialysis (PD) patients have not been fully investigated.

This retrospective, observational study included 75 PD patients. Various parameters were compared during the first 6 months of IBPB administration.

While transferrin saturation, ferritin, hemoglobin (Hb), and mean corpuscular hemoglobin (MCH) increased significantly, red blood cell (RBC) count had no significant change and erythropoiesis-stimulating agent (ESA) doses decreased significantly after 6 months of IBPB administration. Furthermore, even in patients whose ESA dose had not changed by 2 months after starting IBPB administration, Hb, RBC count, and MCH were significantly increased at the second month.

Regardless of the type of IBPB, administration of IBPB resulted in significant iron supplementation and Hb elevation, and the mechanism behind this was not only the increase in MCH due to iron supplementation but also an increase in RBC counts.