Abstract: FR-PO148
Serum Phosphorus and Pill Burden Decreases Among In-Center Hemodialysis (ICHD) Patients Switched to Sucroferric Oxyhydroxide for 12 Months
Session Information
- Bone and Mineral Metabolism: Phosphorus, FGF23, Vascular Calcification
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Rastogi, Anjay, UCLA, Los Angeles, California, United States
- Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Parameswaran, Vidhya, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
According to DOPPS data, >75% of ICHD patients (pts) are prescribed phosphate binders (PB) for the control of serum phosphorus (sP); however, >35% of pts have hyperphosphatemia (sP>5.5 mg/dl). The current analysis is a 12-month follow-up on sP and PB pill burden changes in ICHD pts switched from another PB to sucroferric oxyhydroxide (SFO) as part of routine care.
Methods
This retrospective database analysis utilizes de-identified clinical data extracted from electronic health records from a large dialysis organization (LDO; DaVita Inc) and prescription records from the LDO’s pharmacy service. Adult ICHD pts who received 1 year of SFO monotherapy between 5/1/2014 and 9/30/2018 were included in the analysis. Baseline (BL) and follow-up (Q1-Q4) were divided into 3-month intervals. Mixed effects linear regression and Cochran's Q test were used to test for statistical significance.
Results
Pts (n=364) had a mean BMI of 29.8 and dialysis vintage of 52.6 months. 53% of pts were male and most (74%) had a fistula for vascular access. Sevelamer was the most frequently prescribed monotherapy BL PB (64%), followed by calcium acetate (18%) and lanthanum carbonate (7%), and the remaining pts either switched between PB or had combination therapy. Comparisons between BL and SFO follow-up on mineral bone disease markers and PB pill burden are shown in Table. There were consistent improvements in pts achieving sP ≤5.5 mg/dL (increased from 18% at BL to 36.8-38.7% during SFO, p<0.001). Pts were prescribed an average of 9.3 pills/day at BL and 4.3 to 4.9 pills/day during Q1-Q4. Pts who achieved quarterly sP ≤ 5.5 mg/dl had a mean pill burden of 4.7 pills/day and mean sP of 4.72 mg/dL.
Conclusion
ICHD pts from an LDO prescribed to switch PB to SFO as part of routine care for 12 months, experienced significant reductions in sP along with a 47% reduction in PB pills/day and increase in the % of pts with sP ≤5.5 mg/dl.
| BL | Q1 | Q2 | Q3 | Q4 | p-value | |
| PB pill burden (pills/day) | 9.3 | 4.3** | 4.7** | 4.8** | 4.9** | <0.001 |
| Serum phosphorus (mg/dL) | 6.77 | 6.13** | 6.07** | 6.08** | 6.13** | <0.001 |
| Patients with sP ≤ 5.5 mg/dL (%) | 18.4 | 36.8** | 38.7** | 38.5** | 38.7** | <0.001 |
| Patients with sP ≤ 4.5 mg/dL (%) | 3.6 | 11.5* | 11.8* | 14.3** | 12.4* | <0.001 |
| Serum calcium (mg/dL) | 9.0 | 8.97 | 9.0 | 9.0 | 8.98 | 0.47 |
| Intact PTH (pg/mL) | 622 | 650 | 657* | 681** | 712** | <0.001 |
* p<0.05; ** p<0.001
Funding
- Commercial Support –