Abstract: TH-PO780
Patient Characteristics and Correlates of Patiromer Initiation for Hyperkalemia in Hemodialysis
Session Information
- Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular
Authors
- Rowan, Christopher G, COHRDATA, Santa Monica, California, United States
- Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
- Oestreicher, Nina, Relypsa Inc., a Vifor Pharma Company, Redwood City, California, United States
- Rakov, Viatcheslav, Vifor Pharma, St. Gallen, SG, Switzerland
- Connaire, Jeffrey J., DaVita Clinical Research, Minneapolis, Minnesota, United States
- Spiegel, David M., Relypsa Inc., a Vifor Pharma Company, Redwood City, California, United States
- Kovesdy, Csaba P., University of Tennessee, Memphis, Tennessee, United States
Background
Patiromer is a novel potassium-binding polymer for treatment of chronic hyperkalemia. We retrospectively compared U.S. hemodialysis (HD) patients (pts) who initiated patiromer vs sodium polystyrene sulfate (SPS) in typical practice.
Methods
We identified new users of patiromer or SPS between 12/2015-12/2016 from a large U.S. dialysis provider. Baseline characteristics were obtained in the year prior to the 1st patiromer or SPS order. We identified correlates of patiromer vs SPS using multivariable logistic regression.
Results
Pts initiating patiromer vs SPS were less likely to be black, more likely to use a dialysate K+<2 mEq/L; had higher serum K+, and more electrolyte-related hospitalizations (Table). Having ≥3 serum K+ tests ≥5.0 was associated with 5x the odds of initiating patiromer vs SPS (Figure).
Conclusion
Multiple hyperkalemia episodes and a recent SPS order were associated with patiromer initiation. Patiromer may be used predominantly in HD pts with more severe hyperkalemia who failed SPS. Studies are needed to determine the clinical impact of patiromer.
Table. Baseline Characteristics
| Baseline Characteristics | Patiromer (N=527) | SPS (N=852) | Baseline Characteristics | Patiromer (N=527) | SPS (N=852) |
| Age: Mean (SD) | 59 (14) | 61 (14) | SPS order 91 days b/f index date | 10.80% | 5.30% |
| Female | 43.1% | 47.1% | Insulin order 1 year b/f index date | 23.90% | 30.00% |
| Race: Black | 17.1% | 29.9% | K+ mEq/L: Mean (SD) | 5.8 (0.7) | 5.4 (1.0) |
| Primary Payer: Medicare | 79.5% | 80.0% | # K+ tests ≥5.0 mEq/L: 91 days b/f index date | 8.4 (4.1) | 4.8 (4.3) |
| Dialysis Vintage (years): Mean (SD) | 5.7 (4) | 5.4 (4.4) | Kt/V: Mean (SD) | 1.6 (0.3) | 1.6 (0.3) |
| # HD treatments 91 days b/f index date | 37.8 (3.6) | 37.2 (4.2) | nPCR: Mean (SD) | 1.2 (0.3) | 1.1 (0.3) |
| K+ dialysate <2 mEq/L | 32.3% | 19.2% | Hospitalization: 1 year b/f index date | 60.30% | 67.70% |
| Peripheral Vascular Disease | 10.2% | 4.8% | Electrolyte Related Hospitalization | 14.40% | 8.50% |
Figure. BaselineCorrelates of Patiromer Initiation
Funding
- Commercial Support – Relypsa, Inc., a Vifor Pharma Company