Ferrous calcium citrate 181.5mg tablets

Background: The application of ferric citrate therapy has yielded unexpected benefits in recent years for Chronic kidney disease patients suffering from hyperphosphatemia and iron deficiency -anaemia. Despite this, earlier research on the impact of ferric citrate on NDD-CKD has been contentious. Objective: The goal of the meta-analysis is to evaluate the evidence regarding the advantages and dangers of ferric citrate for the treatment of hyperphosphatemia and iron deficiency anaemia in NDD-CKD patients. Methods: Between the start of the study and June 2022, we searched PubMed, Embase, Cochrane, EBSCO, Scopus, Web of Science, Wan Fang Data, CNKI, and VIP databases for randomised controlled trials of iron citrate for hyperphosphatemia and anaemia in patients with NDD-CKD. For binary categorical data, risk ratios (OR) were employed, and for continuous variables, weighted mean differences The effect sizes for both count and measurement data were expressed using 95% confidence intervals Results: The meta-analysis includes eight trials with a total of 1281 NDD-CKD patients. The phosphorus-lowering effect of ferric citrate was greater compared to the control group (WMD, -0.55, 95% CI, -0.81 to -0.28; I2 = 86%, p p > 0.05; I2 = 61.9%), PTH (WMD, -0.10; 95% CI, -0.44 to 0.23; I2 = 75%, p > 0.05) and iFGF23 (WMD, -7.62; 95% CI, -21.18 to 5.94; I2 = 20%, p > 0.05) levels were not statistically different after ferric citrate treatment compared to control treatment. Furthermore, ferric citrate increased iron reserves and haemoglobin. The ferric citrate group had considerably greater levels than the controls. Ferric citrate, on the other hand, may raise the risk of constipation, diarrhoea, and nausea. Conclusion: This meta-analysis found that ferric citrate had a beneficial effect in the treatment of NDD-CKD, particularly in reducing blood phosphorus levels when compared to a control intervention. It also shown that ferric citrate has a favourable effect on iron intake and anaemia management. In terms of safety, ferric citrate may increase the likelihood of gastrointestinal side effects.

Abstract licence: CC BY

ObjectiveTo evaluate the efficacy and safety of 12 phosphorus-lowering drugs for hyperphosphatemia in chronic kidney disease 3-5 stages.Study design & methodsSystematic review and network meta-analysis of randomized controlled trials (RCTs). We searched 3 databases from inception through September 2023 for RCTs evaluating 12 phosphorus-lowering drugs. We performed frequentist random-effects network meta-analyses and present mean differences and 95% CIs. Subgroup analyses were performed between the dialysis and nondialysis patients to assess robustness, source of heterogeneity, and risk of bias using the Cochrane risk of bias assessment tool.ResultsWe included 121 trials (18,376 participants) and compared 13 drugs or placebo. In terms of efficacy, except for sodium ferrous citrate, all drugs lowered the level of serum phosphorus compared with placebo. Sucroferric oxyhydroxide (PA21), nicotinic acid, and tenapanor were most likely to be ranked the best, second best, or third best. Calcium/magnesium carbonate, nicotinic acid, and colestilan posed lower risks for hypercalcemia than calcium-based phosphorus binders. All phosphorus-lowering drugs significantly affect serum intact parathyroid hormone levels compared with placebo. Colestilan, tenapanor, and PA21 posed a higher risk for gastrointestinal discomfort. In addition, iron-containing drugs showed positive effects on iron parameters.LimitationsFew high-quality RCTs; unclear allocation concealment and blinding; low evidence quality reduced reliability.ConclusionsPA21 has the best phosphorus-lowering effect in hyperphosphatemic adults with chronic kidney disease; considering efficacy and safety, calcium carbonate shows evidence of being the most appropriate drug with or without dialysis.RegistrationRegistered at PROSPERO (CRD42024500243).

Abstract licence: CC BY-NC-ND

Abstract Background Calcium supplementation is only recommended to treat enteric hyperoxaluria, and its effect on idiopathic hyperoxaluria has not been thoroughly assessed. In this study, we compare the effect of calcium citrate supplementation with adequate dietary calcium intake on 24-hour urine (24-U) oxalate, calcium, and calcium oxalate supersaturation index (Ca Ox SS). Subjects: In a parallel-group controlled randomized clinical trial, 72 recurrent calcium stone formers with idiopathic hyperoxaluria were recruited from a tertiary stone prevention clinic in 2019–2020. 24-hour urine analyses and filling the 24-hour food recall were done at baseline and after eight weeks of intervention. Finally, 44 patients completed the study protocol. The participants were randomly assigned to receive adequate calcium through diet or taking 800 mg calcium citrate (in two divided doses with lunch and dinner) with a limited intake of dairy products. The study’s outcome was the change of 24-U Ox, Ca, and CaOx SS index after intervention. Results Findings showed that both interventions significantly reduced 24-U Ox (B Time effect: -10.06, 95% CI: -13.70, -6.42; p < 0.001) and CaOx SS index (B Time effect: -2.54, 95% CI: -4.06, -1.02; p = 0.001). After adjusting the effect of potential confounders through a Random-effects ML regression, the reduction of 24-U Ox remained significant. There was no significant increase in 24-U Ca in both intervention groups (p = 0.269). Conclusions Calcium citrate supplementation effectively reduces 24-U Ox levels comparably to adequate dietary calcium intake, without significantly raising 24-U Ca levels, offering a viable management option for calcium stone formers with idiopathic hyperoxaluria.

Abstract licence: CC BY 4.0