Kidney Week

Abstract: TH-PO196

Serum Phosphorus (sP) Lowering Effect of Sucroferric Oxyhydroxide (SO) in Phosphate-Binder (PB) Naïve Hemodialysis Patients (pts) over 12 Months

Session Information

• Bone and Mineral Metabolism: Clinical - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 402 Bone and Mineral Metabolism: Clinical

Authors

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

Kamyar Kalantar-Zadeh,

• Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States

Linda Ficociello,

• Parameswaran, Vidhya, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States

Vidhya Parameswaran,

• Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States

Claudy Mullon,

• Kossmann, Robert J., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States

Robert J. Kossmann,

• Sprague, Stuart M., NorthShore University HealthSystem University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States

Stuart M. Sprague,

Background

Achieving recommended levels of sP ≤5.5 mg/dL by restricting dietary phosphate alone can be a major challenge and may compromise nutritional status leading to poor outcomes in hemodialysis (HD) pts. Whereas most HD pts are prescribed PB therapy to control sP, the efficacy and bill burden vary substantially across agents. We hypothesize that SO can effectively control sP with a low PB pill burden in pts naïve to PB.

Methods

Data, rendered de-identified, were extracted for all adult, HD pts with their first SO prescription between 3/1/2014-3/1/2015 and SO prescription for 12 months. 172 adult HD pts with SO prescribed as a first-line PB were identified. A subset of 44 pts prescribed SO as late as one year after dialysis start were also analyzed. Baseline (BL) was defined as the 3 months before SO (-Q1) and SO follow-up was divided into quarters (Q1-Q4).

Results

Pts were 54 (±14) years old with a dialysis vintage of 49 (±52) months. Comparing BL vs SO follow-up (Q1-Q4) among all 172 pts, there were consistent improvements in pts achieving target sP ≤5.5 mg/dL (increased from 23.7% at BL to 32.6%-38.8% during SO treatment, p<0.0001) [Figure]. Pts were prescribed between 4.0–4.1 SO pills/day. For the subset of 44 pts prescribed SO during the first year of dialysis, 31.8% of pts had sP ≤5.5 mg/dl at BL and during SO follow-up, 40.9%-52.4% of pts had a sP ≤5.5 mg/dl, a 29%-65% increase from baseline. Mean PB pills/day for this subset ranged from 3.7 to 3.9 pills/day during Q1-Q4.

Conclusion

SO was effective in achieving sP ≤5.5 mg/dL as a first line PB with a low pill burden (4.0–4.1 pills/day) in HD pts. This was confirmed in a subset of pts who began HD as late as one year of starting SO.

Funding

• Commercial Support –