Incidence, mechanism, and consequences of IV iron–induced hypophosphatemia

EVIDENCE-BASED MINIREVIEW| December 8, 2023 Incidence, mechanism, and consequences of IV iron–induced hypophosphatemia Evidence-Based Minireview Kylee L. Martens, Kylee L. Martens 1Division of Hematology & Medical Oncology, Oregon Health & Science University, Portland, OR Search for other works by this author on: This Site PubMed Google Scholar Myles Wolf Myles Wolf 2Division of Nephrology, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC Correspondence Myles Wolf, 2 Genome Court, Room 1009, Durham, NC 27710; e-mail: myles.wolf@duke.edu. Search for other works by this author on: This Site PubMed Google Scholar Hematology Am Soc Hematol Educ Program (2023) 2023 (1): 636–639. https://doi.org/10.1182/hematology.2023000521 Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Request Permissions Cite Icon Cite Search Site Citation Kylee L. Martens, Myles Wolf; Incidence, mechanism, and consequences of IV iron–induced hypophosphatemia. Hematology Am Soc Hematol Educ Program 2023; 2023 (1): 636–639. doi: https://doi.org/10.1182/hematology.2023000521 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsHematology, ASH Education Program Search Learning ObjectivesDefine the incidence and risk factors for intravenous iron–induced hypophosphatemia, which is primarily caused by ferric carboxymaltoseExplain the underlying pathophysiology of intravenous iron–induced hypophosphatemia and how elevations of FGF23 cause renal phosphate wastingRecognize signs and symptoms of severe hypophosphatemia to guide appropriate management A 23-year-old woman presents with progressive fatigue and decreased exercise tolerance. Because of suspected iron deficiency from heavy menstrual bleeding, she was previously advised to take oral iron, but gastrointestinal distress limits her adherence. Laboratory testing reveals iron deficiency anemia: hemoglobin 9.8 g/dL and ferritin 4 ng/mL. She is referred for intravenous (IV) iron and gynecologic management of heavy menstrual bleeding. Based on the infusion clinic's formulary, she receives 2 weekly doses of ferric carboxymaltose (FCM), 750 mg each. One week later, she continues to experience fatigue and weakness, and she now describes... References 1.Auerbach M, Macdougall I. The available intravenous iron formulations: history, efficacy, and toxicology. Hemodial Int. 2017;21:S83-S92. doi:10.1111/hdi.12560.Google ScholarCrossrefSearch ADS PubMed 2.Schaefer B, Tobiasch M, Viveiros A, et al. Hypophosphataemia after treatment of iron deficiency with intravenous ferric carboxymaltose or iron isomaltoside—a systematic review and meta-analysis. 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Bone-derived C-terminal FGF23 cleaved peptides increase iron availability in acute inflammation. Blood. 2023;142(1):106-118. doi:10.1182/blood.2022018475.Google ScholarPubMed Copyright © 2023 by The American Society of Hematology2023 Copyright © 2023 by The American Society of Hematology2023 You do not currently have access to this content.