This research study is for participants that have End Stage Renal Disease (ESRD). ESRD is the
last stage of chronic kidney disease. Anemia is very common in ESRD patients and require
erythropoiesis-stimulating agents (ESAs) for treatment. Anemia happens when there are not
enough red blood cells in your body. ESAs work by helping the bone marrow to produce red
blood cells. There are two ESAs licensed for the treatment of anemia of Chronic Kidney
Disease (CKD) in the Unites States: epoetin alfa and darbopoetin alfa. ESA therapy is
considered safe. However, major adverse effects should be acknowledged, including an
increased risk of death, thromboembolic complications, stroke, heart attack, aplastic anemia,
tumor progression, and others. To minimize risks of these adverse events, careful monitoring
of hemoglobin levels, along with adjustment of ESA dosing, to maintain the lowest hemoglobin
level clinically needed is recommended.
Ferric Citrate, also called Auryxia, is an iron-based phosphate binder that may decrease ESA
usage while maintaining hemoglobin levels. Phosphate binders are medications used to reduce
the body's absorption of phosphate. In a prior study, it was seen that some laboratory
values, such as iron levels, changed positively in response to Auryxia. In this study we want
to see if using Auryxia will cause a change in laboratory values and lower the use of ESAs in
ESRD patients.