The impact of ferric carboxymaltose treatment on serum phosphorus levels in chronic kidney disease

Purpose: This study aimed to investigate the effect of ferric carboxymaltose (FCM) replacement on mineral metabolism parameters, mainly the phosphorus, and the anemia profile in patients with chronic kidney disease (CKD). Materials and Methods: A total of 59 patients with CKD who received FCM treatment for iron deficiency anemia were included in this study conducted between September 2018 and March 2020. All patients received single-dose 1000 mg FCM and post-treatment 1st month and 3rd month laboratory parameters were recorded. Results: Pre-treatment mean +/- SD serum phosphorus levels were 3.82 +/- 0.65 mg/dL, hemoglobin levels were 11.19 +/- 1.55 g/dL and ferritin levels were 25.70 (11.90-54.70) mu g/L. After 1-month FCM treatment, hypophosphatemia was noted in 19(32.2%) patients with decrease from baseline serum phosphorus levels by 17.8%, while no significant change occurred in PTH, 25(OH)D vitamin, creatinine and eGFR levels. None of patients developed adverse events related to FCM. In the 3rd month of treatment, hemoglobin levels were increased by >= 1 g/dL in 25(42.3%) patients. Conclusion: In CKD patients not on dialysis, FCM seems to be a fast acting parenteral treatment alternative with favorable tolerance. Hypophosphatemia develops as an asymptomatic and transient side effect in most of cases with significant impact on treatment decision.