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Abstract: TH-PO204

Safety, Efficacy, and Cost-Effectiveness of Mg/Al Type Hydrotalcite Drug versus Conventional Phosphate Binders in Hemodialysis CKD Patients with Hyperphosphatemia

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Chen, Yingying, Department of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, China
  • Chen, Lan, Department of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, China
  • Guan, Tianjun, Department of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, China
  • Ling, Yisheng, Department of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, China
Background

Hyperphosphatemia is a risk factor for the increased of mortality rates in chronic kidney disease (CKD) patients and associated to several clinical diseases. In this study, we assess safety, efficacy and clinical cost between Mg/Al hydrtoalcite (Talcid) and conventional non-calcium, non-aluminum phosphate binders (Lanthanum carbonate, LC) for hemodialysis (HD) chronic kidney disease (CKD) patients with hyperphosphatemia.

Methods

In this open-label, randomized, parallel-group study, 64 maintenance hemodialysis patients were matched to our selected procedure. Serum phosphate levels were over 1.78 mmol/L (5.5 mg/dl) and they were randomized to treat Talcid 1000 mg three times/day or LC 500 mg two or three times/day for 6 months. Serum calcium, phosphate, parathyroid hormone (iPTH) and alkaline phosphatase (ALP) levels were examined serially for 6 months.

Results

In hemodialysis patients with hyperphophatemia, both Talcid and LC significantly moderated serum phosphate levels, from 2.323±0.392 to 1.702±0.360 mmol/L(P<0.01) and from 2.379±0.393 to 1.890±0.403 mmol/l (P<0.01), respectively. Serum calcium and intact parathyroid hormone (iPTH) level in the both groups did not significantly change when comparing to baseline parameters during the study. No severely adverse events were reported on both groups. Total cost of 6-month treatment with Talcid was 839.79±96.97 RMB while 6-month treatment with LC was 10292.96±4018.10 RMB (P<0.01).

Conclusion

The efficacy and safety of hydrotalcite are similar to LC but it presents higher reaching-target rate and lower economic burden in hemodialysis CKD patients with hyperphosphatemia. It can be severed as another option for dialysis patients with hyperphosphatemia patients.

Comparisons of the daily average cost and total cost between Talcid group and LC group during 6 months treatment.
6 monthsTalcid groupLC groupp-value
Average dose / day(mg)2687.50±310.341191.31±465.06<0.001 **
Total cost(RMB)839.79±96.9710292.96±4018.10<0.001 **

Data are presented as mean+SD ** P < 0.001, Talcid group verse LC group