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Kidney Week

Abstract: TH-PO1032

Changes in Mineral Bone Disease (MBD) Markers in Hemodialysis (HD) Patients Switched to Sucroferric Oxyhydroxide (SO)

Session Information

Category: Mineral Disease

  • 1201 Mineral Disease: Ca/Mg/PO4

Authors

  • Shori, Sandeep, None, Westlake, Texas, United States
  • Parameswaran, Vidhya, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ficociello, Linda H., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Elevated levels of MBD markers (sP, PTH, Ca) increase patient’s risk of morbidity and mortality. This current analysis assesses the changes in MBD markers in patients who lower sP to ≤ 5.5 mg/dl when switching to SO.

Methods

Adult, baseline (BL) hyperphosphatemic (sP> 5.5 mg/dl) Fresenius Kidney Care HD patients switched to SO as part of routine clinical care during 1/1/14 -12/31/16 and maintaining sP ≤ 5.5 mg/dl for 2 quarters (Q1, Q2) after the switch were eligible. BL was defined as the 3 months before SO, when prior phosphate binders (PB) was used. Mean prescribed PB pills/day, sP, Ca, and PTH levels were calculated using mixed effects linear regression.

Results

At baseline the majority of patients were treated with sevelamer (66%), followed by calcium acetate (28%), lanthanum carbonate (5%) and ferric citrate (1%). MBD markers and number of phosphate binder pills/day at BL, Q1 and Q2 for 394 patients who achieved sP ≤ 5.5 mg/dl during Q1 and Q2 are presented in the table.

Conclusion

In a cohort of hyperphosphatemic HD patients switching to SO, improvements in achieving sP ≤ 5.5 mg/dl were accompanied by improvements in Ca and PTH and a 46% reduction in number of phosphate binder pills/day.

 Baseline (Prior PB)SO follow-up Q1SO follow-up Q2p-value
Serum Phosphorus (sP, mg/dl)6.34.84.6<0.0001
Serum Calcium (Ca, mg/dl)9.29.29.10.002
Intact Parathyroid Hormone (PTH, pg/ml)540448470<0.0001
Phosphate Binder pills/day7.94.24.3<0.0001

Funding

  • Commercial Support