{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:04:58Z","timestamp":1791475498996,"version":"4.3.4"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"name":"Akebia Therapeutics, Inc"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR003096"],"award-info":[{"award-number":["UL1TR003096"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute Of Diabetes And Digestive And Kidney Diseases","doi-asserted-by":"publisher","award":["P30DK079626"],"award-info":[{"award-number":["P30DK079626"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute Of Diabetes And Digestive And Kidney Diseases","doi-asserted-by":"publisher","award":["P30DK056336"],"award-info":[{"award-number":["P30DK056336"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute Of Diabetes And Digestive And Kidney Diseases","doi-asserted-by":"publisher","award":["K24DK116180"],"award-info":[{"award-number":["K24DK116180"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Ferric citrate is an oral medication approved for treatment of iron deficiency anemia in patients with CKD not requiring dialysis. The relative efficacy of ferric citrate versus ferrous sulfate in treating iron deficiency in patients with CKD is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>\n                      We randomized 60 adults with moderate to severe CKD (eGFR 15\u201345 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ) and iron deficiency (transferrin saturation [TSAT] \u226430% and ferritin \u2264300 ng\/ml) to ferric citrate (2 g three times a day with meals,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =30) or ferrous sulfate (325 mg three times a day,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =30) for 12 weeks. Primary outcomes were change in TSAT and ferritin from baseline to 12 weeks. Secondary outcomes were change in hemoglobin, fibroblast growth factor 23 (FGF23), and hepcidin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were well balanced between study arms. There was a greater increase in TSAT (between-group difference in mean change, 8%; 95% confidence interval [95% CI], 1 to 15;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.02) and ferritin (between-group difference in mean change, 37 ng\/ml; 95% CI, 10 to 64;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.009) from baseline to 12 weeks in participants randomized to ferric citrate as compared with ferrous sulfate. Similarly, as compared with ferrous sulfate, treatment with ferric citrate resulted in a greater increase in hepcidin from baseline to 12 weeks (between-group difference, 69 pg\/ml; 95% CI, 8 to 130). There were no between-group differences in mean change for hemoglobin (0.3 g\/dl; 95% CI, \u22120.2 to 0.8), intact FGF23 (\u221229 pg\/ml; 95% CI, \u221259 to 0.1), or C-terminal FGF23 (61 RU\/ml; 95% CI, \u2212181 to 58). The incidence of adverse events did not differ between treatment arms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As compared with ferrous sulfate, treatment with ferric citrate for 12 weeks resulted in a greater mean increase in TSAT and ferritin concentrations in individuals with moderate to severe CKD and iron deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial registry name and registration number<\/jats:title>\n                    <jats:p>Impact of Ferric Citrate vs Ferrous Sulfate on Iron Parameters and Hemoglobin in Individuals With Moderate to Severe Chronic Kidney Disease (CKD) With Iron Deficiency, NCT02888171.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.15291219","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T22:55:11Z","timestamp":1595372111000},"page":"1251-1258","source":"Crossref","is-referenced-by-count":29,"title":["Effect of Ferric Citrate versus Ferrous Sulfate on Iron and Phosphate Parameters in Patients with Iron Deficiency and CKD"],"prefix":"10.2215","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct02888171","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02888171","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Rebecca","family":"Womack","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-0994","authenticated-orcid":false,"given":"Fabian","family":"Berru","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhupesh","family":"Panwar","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6593-3571","authenticated-orcid":false,"given":"Orlando M.","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama"},{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2215\/CJN.01670408","article-title":"Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004","volume":"4","author":"Fishbane","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1053\/j.ajkd.2014.10.014","article-title":"A 12-week, double-blind, placebo-controlled trial of ferric citrate for the treatment of iron deficiency anemia and reduction of serum phosphate in patients with CKD Stages 3-5","volume":"65","author":"Block","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1681\/ASN.2016101053","article-title":"Effects of ferric citrate in patients with nondialysis-dependent CKD and iron deficiency anemia","volume":"28","author":"Fishbane","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1016\/j.pcl.2013.08.012","article-title":"Hematologic manifestations of systemic disease (including iron deficiency, anemia of inflammation and DIC)","volume":"60","author":"Witmer","year":"2013","journal-title":"Pediatr Clin North Am"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1038\/ki.2015.163","article-title":"A randomized trial of intravenous and oral iron in chronic kidney disease","volume":"88","author":"Agarwal","year":"2015","journal-title":"Kidney Int"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1093\/ndt\/gfu201","article-title":"FIND-CKD: A randomized trial of intravenous ferric carboxymaltose versus oral iron in patients with chronic kidney disease and iron deficiency 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