Kidney Week

Abstract: TH-PO1030

Two Year Follow Up on Chronic Hemodialysis (HD) Patients Prescribed Sucroferric Oxyhydroxide as Part of Routine Care

Session Information

• Mineral Disease: Ca/Mg/PO4
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

• 1201 Mineral Disease: Ca/Mg/PO4

Authors

• Sprague, Stuart M., NorthShore University HealthSystem University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States

Stuart M. Sprague,

• Parameswaran, Vidhya, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Vidhya Parameswaran,

• Ficociello, Linda H., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Linda H. Ficociello,

• Ofsthun, Norma J., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Norma J. Ofsthun,

• Mullon, Claudy, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Claudy Mullon,

• Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Robert J. Kossmann,

• Coyne, Daniel W., Washington University School of Medicine, St. Louis, Missouri, United States

Daniel W. Coyne,

Background

Controlling serum phosphorus (sP) in HD patients is challenging, in part, due to lack of compliance with the high pill burden typically associated with phosphate binder (PB) therapy. Sucroferric oxyhydroxide (SO) is a PB with a starting dose of 3 pills per day. The current analysis aimed to assess the long-term effectiveness of SO in lowering sP and PB pill burden.

Methods

Adult Fresenius Kidney Care HD patients switched during 1/1/14 -3/31/15 from PB monotherapy to SO monotherapy and continued on SO for two years were included (n=241). Baseline was defined as the 3 months before SO, when prior PB was used. Mean prescribed PB pills/day and sP levels were calculated using mixed effects linear regression. In-range sP was defined as sP ≤ 5.5 mg/dl.

Results

Patients had a mean age of 54 years and dialysis vintage of 57 months at baseline. The majority of patients (67%) were on sevelamer before switching to SO. Mean pill burden decreased by 48-53% from baseline (9.4 pills/day) to SO follow-up (4.4-4.9 pills/day). Prior to switching to SO, 15.8% of patients had a sP ≤ 5.5 mg/dl, after switch this increased to 30.8% at Q1 (a 95% increase or 1.9x from baseline) to 44.1% at 2 years (a 179% increase or 2.7x from baseline) [Figure].

Conclusion

During two year follow-up after switching PB to sucroferric oxyhydroxide, patients were 1.9x to 2.7x more likely to have sP ≤ 5.5 mg/dl (95%-179% increase from baseline) while being prescribed 50% less PB pills/day compared to baseline.

Funding

• Commercial Support –