ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1043

Four Times Daily versus Three Times Daily Dosing of Phosphorus Binders Does Not Improve Serum Phosphorus in Dialysis Patients

Session Information

Category: Mineral Disease

  • 1201 Mineral Disease: Ca/Mg/PO4

Author

  • Muther, Richard S., Kidney Associates of Kansas City, Kansas City, Missouri, United States
Background

Hyperphosphatemia associates with poor outcomes in ESRD patients. Dietary phosphorus restriction and phosphorus binding compounds taken with meals are the primary (though often ineffective) treatments to limit intestinal phosphorus absorption and lower serum phosphorus. Because phosphorus is known to undergo enterohepatic recirculation, a quality improvement project was conducted to determine whether bedtime administration of phosphate binder could favorably impact serum phosphorus.

Methods

Twenty-nine (29) dialysis patients with hyperphosphatemia received their daily phosphorus binding dose either 3 times a day with meals or 4 times a day with meals and at bedtime for 3 months, crossing over to the alternate dosing schedule for an additional 3 months. The type and total daily dose of binder was not changed and patients continued their usual phosphorus restricted diet.

Results

Standard of care data over the project period was available on 23 patients (3 expired, 2 withdrew, 1 transfer). Serum phosphorus did not change over the 3 month course of treatment, regardless of a 3 times daily with meals (5.63 ± 1.4 to 5.72 ± 1.49) or 4 times daily with meals and at bedtime (5.71 ± 1.01 to 5.95 ± 1.47) dosing schedule. The results were not influenced by baseline serum phosphorus (greater or less than 6.0 mg/dL) or the type of phosphorus binder.

Conclusion

If enterohepatic recirculation of dietary phosphorus affects serum phosphorus in dialysis patients, it does not appear to respond to increasing the frequency of administration of phosphorus binding compounds.