Kidney Week

Abstract: TH-PO197

Serum Phosphorus and Phosphate Binder (PB) Pills/Day Among Hemodialysis Patients Prescribed Sucroferric Oxyhydroxide (SO) for a Year Compared to Patients Who Discontinue SO and Are Prescribed Other PB

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

• Coyne, Daniel W., Washington University School of Medicine, St. Louis, Missouri, United States

Daniel W. Coyne,

• 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,

Background

The high pill burden of most PBs has been associated with hemodialysis (HD) patients’ lack of adherence to prescribed therapy. SO is an iron-based PB indicated for the control of serum phosphorus (sP) in patients with chronic kidney disease on dialysis with a starting dose of 3 pills/day. This retrospective database analysis compared sP levels and PB pills/day for patients who continued use of SO and patients who discontinued SO.

Methods

Analysis included adult, HD patients prescribed PB for 12 months as part of routine care with sP measurements recorded during the quarter (Q) before and 4 Q after switch to SO. Continued use of SO was defined as SO monotherapy for 12 months (cSO-Pt). Discontinuing SO (dSO-Pt) was defined as discontinuation of SO within 90 days of initiation followed by a switch to other PB(s). Pre-SO baseline was 6 months (-Q2 and -Q1) and follow-up was 12 months (Q1 to Q4). Statistical analysis was conducted using chi-square test.

Results

653 cSO-Pt and 2294 dSO-Pt were analyzed. 74% of dSO-Pt had a switch to sevelamer after discontinuing SO. Up to 38.4% of cSO-Pt achieved sP ≤5.5 mg/dL compared to up to 34.4% for dSO-Pt [Figure]. During a 12-month follow-up, crude mean sP was 6.19 mg/dL for cSO-Pt and 6.37 mg/dL for dSO-Pt (p<0.0001). After controlling for age, gender, baseline sP, and baseline serum albumin, the follow-up mean sP was 6.22 mg/dL for cSO-Pt and 6.39 mg/dL for dSO-Pt, p<0.0001. The mean PB pill/day was 4.8 for cSO-Pt and 9.2 for dSO-Pt.

Conclusion

During a 12-month follow-up, SO patients had a lower mean sP, were more likely to achieve in-sP ≤5.5 mg/dl, and were prescribed 50% fewer pills/day than patients who discontinued SO and were prescribed other PB(s).

Funding

• Commercial Support – Fresenius Medical Care Renal Therapies Group