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Iron-based phosphorus chelator: Risk of iron deposition and action on bone metabolism in uremic rats
Author(s) -
Wander Barros do Carmo,
Bárbara Bruna Abreu de Castro,
Luísa Cardoso Manso,
Priscylla Aparecida Vieira do Carmo,
Clóvis Antonio Rodrígues,
Melani Ribeiro Custódio,
Vanda Jorgetti,
Hélady Sanders-Pinheiro
Publication year - 2021
Publication title -
experimental biology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 146
eISSN - 1535-3702
pISSN - 1535-3699
DOI - 10.1177/15353702211057280
Subject(s) - kidney disease , phosphate , medicine , phosphorus , phosphate binder , endocrinology , chemistry , chelation , calcium , renal function , hyperphosphatemia , biochemistry , inorganic chemistry , organic chemistry
Phosphate chelators are frequently used in patients with chronic kidney disease (CKD). New iron-based chelators remain understudied and offer a promising therapeutic option for the control of bone and mineral disorders of chronic kidney disease (BMD-CKD). We assessed the effect of the phosphorus chelator, chitosan-iron III (CH-FeCl), compared to calcium carbonate (CaCO 3 ) in BMD-CKD and the potential iron overload in uremic rats. Thirty-two animals were divided into four groups, namely the control, CKD, CKD/CH-FeCl, and CKD/CaCO 3 groups. CKD was induced by adding 0.75% (4 weeks) and 0.1% (3 weeks) adenine to the diet. The chelators were administered from week 3 through week 7. The renal function, BMD-CKD markers, and histomorphometry of the femur were assessed at week 7. The CKD group showed a significant increase in creatinine (83.9 ± 18.6 vs. 41.5 ± 22.1 µmol/L; P  = 0.001), phosphate (3.5 ± 0.8 vs. 2.2 ± 0.2 mmol/L; P  = 0.001), fractional excretion of phosphorus (FEP) (0.71 ± 0.2 vs. 0.2 ± 0.17; P  = 0.0001), and FGF23 (81.36 ± 37.16 pg/mL vs. 7.42 ± 1.96; P  = 0.011) compared to the control group. There was no accumulation of serum or bone iron after the use of CH-FeCl. The use of chelators reduced the FEP (control: 0.71 ± 0.20; CKD/CH-FeCl: 0.40 ± 0.16; CKD/CaCO 3 0.34 ± 0.15; P  = 0.001), without changes in the serum FGF23 and parathyroid hormone levels. Histomorphometry revealed the presence of bone disease with high remodeling in the uremic animals without changes with the use of chelators. The CH-FeCl chelator was efficient in reducing the FEP without iron accumulation, thereby paving the way for the use of this class of chelators in clinical settings in the future.

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