Auryxia (ferric citrate) / Japan Tobacco, Akebia Therap, Averoa - LARVOL DELTA

Hematochezia: A Rare Presentation of Sevelamer Toxicity (ACG 2025) - "The patient was transitioned to Phoslo with resolution of hematochezia...Although the mechanism for Sevelamer-induced gastrointestinal injury is not entirely understood, GI tract dysmotility and altered enzymatic secretion and absorption are thought to play contributing roles. This case highlights the importance of recognizing the possible severe side effects of medications, especially in patients who are critically ill, so that they may transition to another line of therapy.Figure: Figure 1: Fish-scales, 2 toned with a pink center and yellow edges Sevelamer crystals (hematoxylin-eosin, original magnification x400).Figure: Figure 2: Ulcerations identified during diagnostic colonoscopy."

Chronic Kidney Disease • Dyspepsia • Gastrointestinal Disorder • Metabolic Disorders • Nephrology • Renal Disease

Acorus tatarinowii Schott Attenuates Alzheimer's Disease via Neuronal Ferroptosis Inhibition:A Synergistic Network Pharmacology and Multi-Omics Profiling Study. (PubMed, J Ethnopharmacol) - "ATR ameliorated AD by improving iron metabolism and inhibiting neuronal ferroptosis through activation of Nrf2/GPX4 axis, which provided modern medical evidence for the use of ATR to improve AD."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Metabolic Disorders • GPX4 • TFRC

Cost-Effectiveness Analysis of Tenapanor in Japanese Patients with Hyperphosphatemia on Hemodialysis (KIDNEY WEEK 2025) - "Group A included patients who were controlled with phosphate binders (PBs) and in whom Tenapanor was compared with ferric citrate. Table 1. Base-case analysis ICER: Incremental cost-effectiveness ratio, JPY: Japanese yen, PBs: Phosphate binders, QALY: Quality-adjusted life year."

Clinical • Cost effectiveness • HEOR • Metabolic Disorders • Nephrology • Renal Disease

Comparative Phosphate-Lowering Effects of Tenapanor in Combination with Different Phosphate Binders in Patients on Hemodialysis: A Prospective Pilot Study (KIDNEY WEEK 2025) - "Methods In this prospective study, 55 HD patients were stratified into five groups based on their baseline phosphate binder (PB) use: PB-naïve, calcium-based binders, iron-based binders (ferric citrate), lanthanum carbonate, and polymer-based binders. Although the exact mechanism remains unclear, it is hypothesized that iron-based binders such as ferric citrate may alter intestinal pH—potentially affecting the local action of tenapanor. These preliminary results highlight the importance of binder selection in maximizing tenapanor efficacy and warrant further mechanistic and clinical studies."

Clinical • Combination therapy • Cardiovascular • Metabolic Disorders • Nephrology • Renal Disease

Oxylanthanum Carbonate Achieves Serum Phosphate Control with Significantly Lower Pill Burden in Patients with Hyperphosphatemia on Dialysis (KIDNEY WEEK 2025) - "Pretrial PB included sevelamer carbonate, calcium acetate, ferric citrate, and sucroferric oxyhydroxide. Combined with previously presented safety data, these findings suggest that OLC is safe, effective, and well-tolerated. Its small, easy-to-swallow formulation may be a welcome choice for pts with HP."

Clinical • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Study to Evaluate the Safety and Tolerability of Ferric Citrate in Children With Hyperphosphatemia Related to Chronic Kidney Disease (clinicaltrials.gov) - P3 | N=45 | Suspended | Sponsor: Keryx Biopharmaceuticals | Recruiting ➔ Suspended

Trial suspension • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

A Zn(II)-based metal-organic framework as a turn-off/on fluorescent sensor for selective detection of ammonium ferric citrate and aspirin. (PubMed, Spectrochim Acta A Mol Biomol Spectrosc) - "After IFE correction, the results highlighted genuine molecular interactions between AF and Zn-MOF-1. This establishes Zn-MOF-1 as a sensitive and selective fluorescent sensor for environmental and bioanalytical applications."

Journal

Opposing roles for iron transport systems in gallium tolerance in extraintestinal pathogenic Escherichia coli. (PubMed, J Bacteriol) - "Our findings suggest that enterobactin can complex with gallium for cellular uptake, but that the ferric citrate receptor FecA can discriminate between gallium citrate and iron citrate...Our results are significant as they show that the enterobactin siderophore and the ferric dicitrate iron transport systems expressed by these bacteria have opposing roles in E. coli gallium sensitivity. These findings could be leveraged to enhance the efficacy of gallium therapeutics."

Journal • Infectious Disease

Inhibition of ferroptosis rescues BMP osteogenic differentiation impaired by iron overload in the osteoporotic microenvironment. (PubMed, Cell Signal) - "We then induced iron-overload conditions using ammonium ferric citrate (FAC)...Our findings suggest ferroptosis is a key factor limiting BMP treatment efficacy in osteoporosis. Melatonin holds promise as an effective adjunct therapy to overcome this limitation."

Journal • Hematological Disorders • Orthopedics • Osteoporosis • Rheumatology

Mechanistic studies on the regulation of ferroptosis by ferritin 1 through the FTH1 signaling pathway affecting oocyte maturation. (PubMed, Theriogenology) - "A ferroptosis-induced injury model was established using ammonium ferric citrate (FAC), and a rescue model was established by adding FER-1...Additionally, SLC7A11, FTH1, and GPX4 mRNA levels were significantly increased (P < 0.05), and ACSL4 expression was significantly downregulated (P < 0.05). In summary, FER-1 may reduce ferroptosis in iron-overloaded mature oocytes through the FTH1 signaling pathway."

Journal • Hematological Disorders • ACSL4 • GPX4 • SLC7A11

The metal-organic framework MIL-100(Fe) and ferric citrate as potential counteracting biomaterials against osteoarthritis-induced articular inflammation and fibrosis. (PubMed, Biomed Pharmacother) - "Our data demonstrated that ferric citrate reduced inflammatory cytokine interleukin 6-induced cell injury and promoted their cell proliferation; on the other hand, MIL-100(Fe) effectively mitigated IL6- and TGFβ1-induced fibrosis marker proteins, such as transforming growth factor beta 1, alpha smooth muscle actin, collagen type I, small mother against decapentaplegic 2/3 expressions, but did not enhance the regeneration or proliferation of the synovial-like lining cells, indicating the distinct therapeutic potential of ferric citrate and MIL-100(Fe). Although neither ferric citrate nor ML100(Fe) restored the mitochondrial function, the combination of ferric citrate with ML100(Fe) may enhance the therapeutic efficacy of OA-induced articular inflammation at early stages to prevent further progression toward articular fibrosis and provide better therapeutic outcomes for canine OA patients."

Journal • Fibrosis • Immunology • Inflammation • Osteoarthritis • Pain • Rheumatology • IL6 • TGFB1

Enhanced photo-Fenton degradation of iron-doped carbon dots with boosted Fe (III)/Fe (II) circulation and extended pH range (ACS-Fall 2025) - "Iron-doped carbon dots (Fe-CDs) were synthesized via a hydrothermal reaction with chitin as the carbon source and ammonium ferric citrate (AFC) as the iron source...The iron-doped form with anchoring Fe provides forming ferric precipitation, and enables continuous degradation of MB in a wide pH range (3.0-10.0), overcoming the pH limitations typically associated with conventional Fenton reactions. Our findings demonstrate the potential of Fe-CDs for efficient treatment of organic pollutants, while expand our understanding for environmentally sustainable wastewater treatment."

Dietary Iron Supplementation Protects Against Growth Restriction and Metabolic Dysfunction-Associated Steatotic Liver Disease in Perinatal Cadmium-Exposed Mice. (PubMed, FASEB Bioadv) - "Fe fortification was supplied in the form of dietary ferric citrate, which amounted to two (2×) or five times (5×) the normal dietary Fe in standard chow. Our study provides evidence that perinatal Cd exposure does not prevent absorption of supplemental Fe, and that the chosen Fe supplementation dosages are sufficient to prevent Cd-induced growth restriction, ID, IDA, and MASLD in offspring at postnatal day 21 (PND21). Our findings suggest that Fe supplementation may be a viable therapy to prevent these developmental effects of maternal Cd exposure."

Journal • Preclinical • Fibrosis • Hematological Disorders • Hepatology • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease

Modeling and optimization of bioproduct formation with purple phototrophic bacteria using machine learning. (PubMed, Bioresour Technol) - "The models were trained on a dataset compiled from previous studies, using input variables such as reaction time, concentration of organic matter, ethanol, bicarbonate, levulinic acid, ferric citrate, mineral medium, and N, C/N ratio, illumination conditions (continuous or intermittent), operation mode (batch or semicontinuous), and volume exchange percentage...Optimization suggests that operating as a sequencing batch reactor and employing discontinuous illumination for most targets, along with a reduced mineral medium concentration, is beneficial. Results highlight that each bioproduct requires distinct operational settings, supporting the idea of clustering target compounds."

Journal

Enhancing Catalytic Removal of N-Nitrosodimethylamine from Drinking Water Matrices with One-Step-Carbonized Ferric Ammonium Citrate. (PubMed, Nanomaterials (Basel)) - "Mechanistic insights revealed that superoxide and hydroxyl radicals dominate NDMA degradation, facilitated by the presence of dissolved oxygen and PS. This study underscores the potential of the FAC-600/PS AOP system as a robust and efficient solution for NDMA removal, promising safer drinking water through practical application."

Journal

Isolation and characterization of a bacterium affiliated with the hitherto uncultured candidate phylum WOR-3 from a deep-sea hydrothermal fluid. (PubMed, Appl Environ Microbiol) - "The strain could not use thiosulfate, sulfate, sulfite, fumarate, nitrate, nitrite, selenate, selenite, arsenate, ferric citrate, or ferrihydrite as an electron acceptor...In recent years, the metagenome-assembled genomes have been determined from the environments. In this study, we report on the successful isolation of a thermophilic microaerobic chemoorganoheterotroph, strain sy37, which is phylogenetically belonging to the WOR-3 lineage, from a deep-sea hydrothermal environment for the first time."

Journal

Tenapanor administration combined with phosphate binders provides synergistic phosphate lowering effect (ERA 2025) - "Six types of P binders had been used in Group Ad (sevelamer hydrochloride, bixalomer, calcium carbonate, ferric citrate, sucroferric oxyhydroxide hydrate and lanthanum carbonate hydrate). Oral administration of tenapanor significantly reduced P adsorption and improved serum P level in patients undergoing HD either when it was administrated alone or adding on P binders. This P absorption reduction effect of tenapanor was greatly enhanced when it was added on P binders. The mechanism of this synergistic effect would be an important research question."

Metabolic Disorders • Nephrology • Renal Disease

Vadadustat Combination with Ferric Citrate, Compared to Either Agent Alone, Protects Against Inflammation-Induced Anaemia and Anaemia-Induced by Chronic Kidney Disease (ERA 2025) - "Collectively, these data suggest vadadustat in combination with oral iron provides greater improvement in anaemia related parameters in models of inflammation-induced anaemia and CKD than when either agent is given alone."

Anemia • Chronic Kidney Disease • Hematological Disorders • Inflammation • Nephrology • Renal Disease • CRP • FGF21 • HP • IL15 • IL6

Iron modulates barrier integrity and stem cell function of small intestine during experimental colitis. (PubMed, Front Nutr) - "Iron content was modulated by the supplementation of ferric citrate or depletion by deferoxamine (DFO). In addition, STAT3 and ERK pathways in intestinal epithelium were impaired during experimental colitis, and iron content significantly interrupted the expression of p-STAT3 and p-ERK1/2 within small intestine. In summary, this study proved that small intestine was also impaired in experimental colitis, and iron content could affect DSS-induced small intestinal damage and regeneration, indicating the strategy of iron supplementation in clinical practice needs to be more cautious and consider more factors."

Journal • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • OLFM4

Identification of factors limiting the efficiency of transplanting extracellular electron transfer chains in Escherichia coli. (PubMed, Appl Environ Microbiol) - "These stages were compared to corresponding S. oneidensis strains in terms of anthraquinone-2,6-disulfonate (AQDS) and ferric citrate reduction rates...We could identify the type II secretion system of S. oneidensis as crucial for MtrC secretion in E. coli. Thereby, this work highlights the substrate specificity of bacterial type II secretion systems, suggesting methods to optimize protein production and secretion in bioelectrochemical applications."

Journal • Transplantation

FIT4KID: Ferric Citrate and Chronic Kidney Disease in Children (clinicaltrials.gov) - P2 | N=160 | Recruiting | Sponsor: University of California, Los Angeles | Trial completion date: Dec 2025 ➔ Oct 2027 | Trial primary completion date: Dec 2025 ➔ Oct 2027

Trial completion date • Trial primary completion date • Chronic Kidney Disease • Nephrology • Renal Disease

A Prospective Clinical Study of Ferric Citrate Hydrate for Chronic Heart Failure with Iron Deficiency Anemia. (PubMed, Life (Basel)) - "Ferric citrate hydrate significantly increased hemoglobin, serum iron, transferrin saturation (TSAT), and ferritin levels, and decreased atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Ferric citrate hydrate could be continued without side effects such as gastrointestinal symptoms. Improvement in iron metabolism and anemia due to iron supplementation with ferric citrate hydrate led to improvement in heart failure biomarkers."

Journal • Anemia • Cardiovascular • Congestive Heart Failure • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • NPPB

Cleavage cascade of the sigma regulator FecR orchestrates TonB-dependent signal transduction. (PubMed, Proc Natl Acad Sci U S A) - "Consequently, the successive cleavage of FecR's NTD is initiated, culminating in the ferric citrate signal-induced activation of fec gene expression. Our findings reveal that the regulation of FecR cleavage, controlled by the TonB-FecA axis, plays a central role in the bacterial response to ferric citrate signals."

Journal • Infectious Disease • Targeted Protein Degradation

Study to Evaluate the Safety and Tolerability of Ferric Citrate in Children With Hyperphosphatemia Related to Chronic Kidney Disease (clinicaltrials.gov) - P3 | N=45 | Recruiting | Sponsor: Keryx Biopharmaceuticals | Trial completion date: Jun 2025 ➔ Oct 2026 | Trial primary completion date: Jan 2025 ➔ Dec 2025

Trial completion date • Trial primary completion date • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Iron overload mediates cytarabine resistance in AML by inhibiting the TP53 signaling pathway. (PubMed, Acta Biochim Biophys Sin (Shanghai)) - "In this study, an iron overload model in AML cells via the use of ferric citrate is constructed. In TP53 wild-type AML cells, TFR1 participates in iron-mediated resistance to cytarabine by regulating the entry of iron into the cells. These findings provide a foundation for further exploration of the molecular mechanisms involved in AML resistance to cytarabine."

IO biomarker • Journal • Acute Myelogenous Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • BCL2 • TFRC