| Theme |
Revival of renal osteodystrophy -- new treatment targeting bone |
| Title |
Sucroferric oxyhydroxide |
| Author |
Fumihiko Koiwa |
Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital |
| Author |
Aya Mizukami |
Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital |
| Author |
Yuichi Maruta |
Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital |
| [ Summary ] |
Sucroferric oxyhydroxide (PA21) has been used as an iron-containing phosphate binder following the introduction of ferric citrate hydrate (FC) in Japan. Phosphate binding occurs through ligand exchange between hydroxyl groups and/or water associated with polynuclear iron oxyhydroxide and phosphates in the diet. The structure maintains to binding of phosphorus without iron release, PA21 is different from FC in its pharmacologic mechanism of phosphorus adsorption. Administration of PA21 produced decreased serum phosphate levels at dosages of 250 mg three times/day in a dose dependent manner up to 3,000 mg/day. PA21 produces comparable phosphate lowering effects with low doses, and low pill burdens compared to sevelamer hydroxide. The primary side effect is mild diarrhea. The influence on iron metabolism with PA21 is also mild. The administration of PA21 is considered when we want to reduce the pill burden associated with phosphate binders, and in patients with insufficient phosphate management without strict consideration of iron metabolism. However, the administration of PA21 to the patients possible iron excess should be carefully considered. |