Abstract: TH-PO779

Outcomes in ESRD Patients on Hemodialysis Taking Patiromer for Hyperkalemia

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Chatoth, Dinesh K, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Spiegel, David M., Relypsa Inc., a Vifor Pharma Company, Redwood City, California, United States
  • Weir, Matthew R., University of Maryland Medical Center, Baltimore, Maryland, United States
  • Wahl, Peter M., Covance Market Access Inc., Gaithersburg, Maryland, United States
  • Rakov, Viatcheslav, Vifor Pharma, Glattbrugg, Switzerland
  • Van Zandt, Carly R., Frenova Renal Research, Waltham, Massachusetts, United States
  • Anastassopoulos, Kathryn P., Covance Market Access Inc., Gaithersburg, Maryland, United States
  • Colman, Sam, Covance Market Access Inc., Gaithersburg, Maryland, United States
  • Knight, Tyler, Covance Market Access Inc., Gaithersburg, Maryland, United States
  • Oestreicher, Nina, Relypsa Inc., a Vifor Pharma Company, Redwood City, California, United States
  • Mooney, Ann, Frenova Renal Research, Waltham, Massachusetts, United States
Background

Real-world data on hyperkalemia (HK) treatment with patiromer in dialysis patients in the United States (US) are limited. We sought to examine outcomes of end-stage renal disease (ESRD) patients on hemodialysis (HD) and treated with patiromer for HK at US Fresenius Kidney Care (FKC) centers.

Methods

We identified adult patients who initiated patiromer between 10/1/2015 and 7/31/2016; were prescribed permanent in-center HD ≥3 times per week; and had ≥1 serum potassium (sK) lab value in the 91 days prior to patiromer initiation (baseline). We examined changes from baseline in sK values and potassium (1K) baths over 6 months.

Results

Among 268 patients included in the analysis, mean age was 57.5 years, 55.2% male, and 77.2% white, with a mean of 4.9 years on dialysis. Median patiromer daily dose was 8.4 g/day. Overall, sK decreased by 0.5 mEq/L (decrease of 0.8 and 1.7 among those with baseline sK >5.5 and sK >6.5, respectively) (Table 1). Unobserved events may have prompted treatment in patients with baseline sK <5.5 mEq/L. The percentage of patients treated with 1K baths decreased by 2.2%.

Conclusion

These results demonstrate that treatment with patiromer lowers sK levels in real-world settings, with the greatest effect among patients with sK >6.5 mEq/L. The predominant use of the recommended starting dose (8.4 g/day) supports the feasibility of this dose for long-term (≥6 months) sK control.

Table 1. Change in Serum Potassium Over 6 Months Following Patiromer Initiation
Baseline sK (mEq/L)BaselineFollow-Up Period After Patiromer Initiation
Week 1Week 2Week 3Week 4Month 2Month 3Month 4Month 5Month 6
Overall (N=268)
n (%)268 (100.0)181 (67.5)187 (69.8)191 (71.3)187 (69.8)240 (89.6)211 (78.7)181 (67.5)172 (64.2)156 (58.2)
Mean (SD)5.8 (0.81)5.5 (0.64)5.5 (0.65)5.5 (0.74)5.4 (0.74)5.4 (0.70)5.4 (0.70)5.3 (0.72)5.3 (0.65)5.3 (0.69)
Mean Δ (SD)--0.3 (0.81)-0.3 (0.89)-0.3 (0.92)-0.4 (0.98)-0.4 (0.94)-0.4 (0.88)-0.4 (0.97)-0.5 (0.95)-0.5 (0.96)
≤5.5 mEq/L (N=89)
n (%)89 (100.0)63 (70.8)65 (73.0)69 (77.5)69 (77.5)81 (91.0)75 (84.3)70 (78.7)65 (73.0)60 (67.4)
Mean (SD)4.9 (0.47)5.1 (0.52)5.3 (0.61)5.3 (0.75)5.3 (0.71)5.3 (0.64)5.2 (0.61)5.2 (0.64)5.2 (0.69)5.1 (0.75)
Mean Δ (SD)-0.2 (0.60)0.3 (0.68)0.3 (0.76)0.3 (0.79)0.3 (0.78)0.2 (0.71)0.2 (0.73)0.2 (0.77)0.1 (0.86)
>5.5 mEq/L (N=179)
n (%)179 (100.0)118 (65.9)122 (68.2)122 (68.2)118 (65.9)159 (88.8)136 (76.0)111 (62.0)107 (59.8)96 (53.6)
Mean (SD)6.2 (0.56)5.7 (0.60)5.6 (0.64)5.6 (0.72)5.5 (0.74)5.5 (0.72)5.5 (0.72)5.4 (0.76)5.4 (0.62)5.4 (0.63)
Mean Δ (SD)--0.6 (0.77)-0.7 (0.82)-0.7 (0.82)-0.7 (0.87)-0.7 (0.83)-0.7 (0.80)-0.9 (0.86)-0.9 (0.80)-0.8 (0.83)
>6.5 mEq/L (N=39)
n (%)39 (100.0)34 (87.2)26 (66.7)27 (69.2)25 (64.1)35 (89.7)31 (79.5)30 (76.9)28 (71.8)23 (59.0)
Mean (SD)7.1 (0.55)5.8 (0.65)5.7 (0.70)5.9 (0.67)5.7 (0.80)5.8 (0.84)5.7 (0.84)5.7 (0.79)5.6 (0.70)5.4 (0.73)
Mean Δ (SD)--1.3 (0.70)-1.5 (0.88)-1.2 (0.76)-1.4 (0.88)-1.2 (0.99)-1.3 (0.92)-1.3 (0.86)-1.4 (0.99)-1.7 (0.84)

Abbreviations: Δ, change; SD, standard deviation; sK, serum potassium.

Funding

  • Commercial Support