How often have you seen Ferric Carboxymaltose cause hypophosphatemia? @kidneyboy.bsky.social @hswapnil.medsky.social @askrenal.bsky.social #askrenal pubmed.ncbi.nlm.nih.gov/39659775/ - ThreadSky

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drjmluther.bsky.social • 7 days ago

How often have you seen Ferric Carboxymaltose cause hypophosphatemia? @kidneyboy.bsky.social @hswapnil.medsky.social @askrenal.bsky.social #askrenal

https://pubmed.ncbi.nlm.nih.gov/39659775/

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captainchloride.bsky.social•7 days ago

Seen it a handful of times now that we’ve been using it frequently in our heart failure patients

drjmluther.bsky.social•6 days ago

Interesting- thanks. Making sure that I'm not jumping to conclusions for something that isn't too common.

captainchloride.bsky.social•6 days ago

I wonder how many of these cases go undiagnosed as well. With the iron data in heart failure it’s common for cardiologists to prescribe - how many are checking phos levels?

hswapnil.medsky.social•7 days ago

In CKD it would even be an advantage!

We have easier access to Ferric Derisomaltose (Pfizer https://monoferric.com) than Ferric Carboxymaltose so I haven’t really used it

drjmluther.bsky.social•7 days ago

supposedly the Derisomaltose causes less.
Pathophysiology is really interesting- Carboxymaltose inhibits FGF23 degradation.
Is Myles Wolf on here? @dukekidney.bsky.social

littlebiggloms.bsky.social•6 days ago

Not seen Myles on here and he's left the triangle for the big 🍎, now. Rarely use FCM, but very interesting iron and phosphorous metabolism linkages in the proximal tubule.

hswapnil.medsky.social•7 days ago

I thought that is well established? (FCM > FGF > low PO4)?

I guess it’s a bigger concern when people use it in heart failure when reasonably preserved kidney function and normal PO4 levels?

#cardiosky

drwanpen.bsky.social•7 days ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC10727077/
Good recent review but in CKD , it will increase intact FGF23 more but lower serum PO4

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