{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:35:04Z","timestamp":1783427704222,"version":"3.54.6"},"reference-count":41,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kanazawa Medical University"},{"name":"Torii Pharmaceutical Co., Ltd. (Tokyo, Japan)"},{"name":"Japan Tobacco Inc. (Tokyo, Japan)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (\u0394Fe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to \u0394Fe2h, and the secondary outcome was the description of the predictors of the body\u2019s iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. \u0394Fe2h increased when hepcidin-25 and TSAT decreased (\u22120.459, \u22120.643 to \u22120.276, p = 0.000; \u22120.648, \u22121.099 to \u22120.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (\u22121.392, \u22121.749 to \u22121.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.<\/jats:p>","DOI":"10.3390\/ijms241813779","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T09:51:37Z","timestamp":1694080297000},"page":"13779","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-8116","authenticated-orcid":false,"given":"Naohisa","family":"Tomosugi","sequence":"first","affiliation":[{"name":"Division of Systems Bioscience for Drug Discovery, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku 920-0293, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Koshino","sequence":"additional","affiliation":[{"name":"Mizuho Hospital, Tsubata 929-0346, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Maeda Institute of Renal Research Musashikosugi, Kawasaki 211-0063, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunimi","family":"Maeda","sequence":"additional","affiliation":[{"name":"Maeda Institute of Renal Research Shakujii, Nerima 177-0041, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Shimada","sequence":"additional","affiliation":[{"name":"Tachibana Clinic, Sumida 131-0043, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimio","family":"Tomita","sequence":"additional","affiliation":[{"name":"The Chronic Kidney Disease Research 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