Parenteral iron therapy and phosphorus homeostasis: A review.

Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, USA. David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. St. Mary Medical Center, Langhorne, Pennsylvania, USA. Department of Obstetrics and Gynecology, University of Southern California Verdugo Hills Hospital, Glendale, California, USA. Department of Pathology and Medicine, Stanford University, Stanford, California, USA. Center for Bone Health and Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

American journal of hematology. 2021;(5):606-616

Abstract

Phosphorus has an essential role in cellular and extracellular metabolism; maintenance of normal phosphorus homeostasis is critical. Phosphorus homeostasis can be affected by diet and certain medications; some intravenous iron formulations can induce renal phosphate excretion and hypophosphatemia, likely through increasing serum concentrations of intact fibroblast growth factor 23. Case studies provide insights into two types of hypophosphatemia: acute symptomatic and chronic hypophosphatemia, while considering the role of pre-existing conditions and comorbidities, medications, and intravenous iron. This review examines phosphorus homeostasis and hypophosphatemia, with emphasis on effects of iron deficiency and iron replacement using intravenous iron formulations.

Methodological quality

Publication Type : Review

Metadata

MeSH terms : Phosphorus