Abstract: TH-PO1038

Effect of an Individualized Therapy for Hyperphosphatemia in Hemodialysis Patients – A Single-Center, Open-Label Randomized Clinical Trial

Session Information

Category: Mineral Disease

  • 1201 Mineral Disease: Ca/Mg/PO4

Authors

  • Dong, Xinyu, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Wang, Mengjing, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Zhang, Qian, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Zhang, Jiaying, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Zhang, Minmin, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Ni, Li, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Chen, Jing, Huashan Hosopital, Fudan Univeristy, Shanghai, China
Background

We hypothesized that estimation of phosphorus balance would improve the efficiency of treatment of hyperphosphatemia. Thus we compared individualized therapy with traditional therapy of hyperphosphatemia in maintenance hemodialysis (MHD) patients.

Methods

67 eligible MHD patients with serum phosphate >1.45mmol/L were randomized into Control Group (n=20) and Individualized group (Dietary Group, n=23 and Combined Group, n=24) for 6 weeks. Phosphorus balance was achieved in Individualized group by the following equation: Diet Pi×60% = Pi removed by hemodialysis and phosphate binders. Patients in Dietary Group were assigned diet education and individualized diet for 6 weeks, while patients in Combined Group were assigned individualized diet for 3 weeks following correction of phosphate retention by increased hemodialysis sessions. No estimation of phosphorus balance was assessed in Control Group and patients were assigned conventional HD regimen and phosphate binders according to serum calcium and phosphate. Analysis was done among patients with good compliance.

Results

Mean age of the participants was 57.7±9.0 years old. Baseline serum phosphate was 1.96±0.38 mmol/L, 2.08±0.41 mmol/L and 2.13±0.47 mmol/L in Control, Dietary and Combined Group, respectively. Serum phosphate decreased significantly at Week 3 and Week 6 compared to Baseline in Dietary Group (Week 3: -0.18±0.39, P=0.113; Week 6: -0.41±0.42, P=0.004), and in Combined Group (Week 3: -0.35±0.68, P=0.045; Week 6: -0.26±0.54, P=0.056), but not in Control Group (Week 6: -0.09±0.50, P=0.556). No significant change was found in albumin, creatinine, calcium, iPTH, AKP, and nPCR during the follow-up period.

Conclusion

Individualized therapy was effective and safe in correcting hyperphosphatemia without inducing malnutrition. Current study provided a new and applicable approach in treating hyperphosphatemia in MHD patients.

Funding

  • Government Support - Non-U.S.