Kidney Week

Abstract: TH-PO1033

Serum Albumin and Serum Phosphorus among Hemodialysis Patients after Initiating Sucroferric Oxyhydroxide (SO)

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

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

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

Linda H. Ficociello,

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

Vidhya Parameswaran,

• Mondal, Hasi, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Hasi Mondal,

• Athienites, Nicolaos V., Renal Medical Care PC, Abington, Massachusetts, United States

Nicolaos V. Athienites,

• 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,

Background

Dietary protein intake may result in higher phosphorus burden and increases in serum phosphorus (sP) in hemodialysis (HD) patient, whereas restricting high-protein diet to control phosphorus may lead to hypoalbuminemia. This presents a challenge as both low serum albumin (sAlb) and high sP increase mortality risk. We hypothesized that under routine clinical care scenario, SO can lead to increase in sAlb, while lowering sP and pill burden.

Methods

All adult patients who completed 1 year of uninterrupted SO treatment (Q1-Q4) with sP and sAlb measurements were eligible for the analysis. Hypoalbuminemic patients (Low-Alb) had sAlb ≤ 3.5g/dl during at least one 3 month baseline interval and were matched on gender, race, diabetes status, and age (+/-5 years) to patients with normal sAlb during baseline (Match). 79 matched pairs were created.

Results

The two groups did not differ on matched baseline factors or BMI (31.1 vs 31.2 kg/m²) but Low-Alb patients had a shorter dialysis vintage (32 vs 60 months) at baseline. Comparing baseline to Q4 of SO follow-up, PB pills/day decreased by 44.9 and 45.1% (both p<0.0001) and sP decreased by 0.7 and 0.5 mg/dl (both p<0.0001), for Low-Alb and Match, respectively. Mean sAlb stayed stable in Match, but increased significantly (p<0.0001) in the low sAlb group from 3.49 mg/dl at baseline to 3.71, 3.73, 3.74, and 3.69 mg/dl during Q1-Q4, respectively. Figure 1 shows monthly changes for sP and sAlb.

Conclusion

Lowering of sP and PB pills/day was observed in Low-Alb and Match patients after switch to SO. Low-Alb patients who received SO also experienced significant increases in sAlb.

Funding

• Commercial Support –