Low Molecular Weight Iron Dextran Increases Fibroblast Growth Factor-23 Concentration, Together With Parathyroid Hormone Decrease in Hemodialyzed Patients
Article first published online: 5 JAN 2012
© 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis
Therapeutic Apheresis and Dialysis
Volume 16, Issue 2, pages 146–151, April 2012
How to Cite
Hryszko, T., Rydzewska-Rosolowska, A., Brzosko, S., Koc-Zorawska, E. and Mysliwiec, M. (2012), Low Molecular Weight Iron Dextran Increases Fibroblast Growth Factor-23 Concentration, Together With Parathyroid Hormone Decrease in Hemodialyzed Patients. Therapeutic Apheresis and Dialysis, 16: 146–151. doi: 10.1111/j.1744-9987.2011.01037.x
- Issue published online: 27 MAR 2012
- Article first published online: 5 JAN 2012
- Received July 2011; revised August 2011.
- Bone metabolism;
- Fibroblast growth factor-23;
- Low molecular weight iron dextran;
- Parathyroid hormone
Fibroblast growth factor (FGF)-23 inhibits PTH production. Elevated FGF-23 and parathyroid hormone (PTH) levels are characteristic of hemodialyzed patients. Iron polymaltose was shown to increase FGF-23 concentration. The effect of intravenous low molecular weight iron dextran (LMID) on these hormones and bone metabolism has not been studied in hemodialysis (HD). Twelve HD patients were prospectively followed up for 3 weeks after a single infusion of LMID. Calcium, phosphate, FGF-23, PTH, degradation products of C-terminal telopeptides of type I collagen (CTX) and procollagen I N-terminal propeptide (PINP) were measured prior to, and at week 1 and week 3 after the LMID administration. FGF-23 increased significantly from 453.4 (68.6–3971.5) pg/mL at baseline to 971.8 (779.5–3361.4) pg/mL (P = 0.001) at week 1 and started to decrease toward the initial value at week 3. The changes were accompanied by a significant decline in PTH from 367.6 (21.4–1487.4) pg/mL at baseline to 315.7 (16.4–1339.8) pg/mL (P = 0.018) at week 1 and subsequently began to increase toward the initial values. Phosphate, calcium, CTX and PINP did not change over the study course. LMID causes an increase in FGF-23 concentration together with a decrease in PTH. Our study highlights a pathophysiological element, which may connect suppression of parathyroid glands with intravenous iron supplementation.