Abstract: FR-PO151
Longitudinal Serum Phosphorus Levels over 2 Years in Incident Dialysis Patients Who Initiate Sucroferric Oxyhydroxide (SO) as a First-Line Phosphate Binder
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
- Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, 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
- Sprague, Stuart M., NorthShore University HealthSystem University of Chicago, Chicago, Illinois, United States
Background
Phosphate binder (PB) therapy is usually initiated in the first year of dialysis therapy in chronic hemodialysis (HD) patients (pts). A historical cohort study was conducted to examine longitudinal serum phosphorus (sP) among pts who begin sucroferric oxyhydroxide (SO) as a first-line PB within the first year of HD as part of routine care in real world setting.
Methods
Adult HD pts first prescribed SO between 4/1/14-9/30/17 during their first year of HD were included in this database analysis. Pts were required to have no PB prescription during a 3-month baseline (BL) and continue SO for 2 years. All clinical data was extracted from Fresenius Kidney Care electronic health records, deidentified, and averaged over each quarter (Q1-Q8). Mixed effects linear regression and Cochran's Q test were used for statistical significance testing.
Results
Pts (n=59) had a mean age of 56+13 years and dialysis vintage of 7.3+2.9 months at BL. Changes in mean sP, serum calcium, PTH, and Kt/V are provided [table]. After SO initiation, overall mean sP decreased by 0.7 mg/dl and % of pts achieving sP ≤ 5.5 mg/dl increased from 36.5% at BL to a high of 64.9%. After limiting to pts with BL sP > 5.5 mg/dl, mean sP decreased by 1 mg/dl, from 6.86 to 5.86 mg/dl, with a high of 48.4% of pts achieving sP ≤ 5.5 mg/dl. These pts were prescribed, on average, 4.9-5.9 SO pills/day.
Conclusion
HD pts initiating SO as a first-line PB within the first year of dialysis were able to reduce mean sP levels by 0.7 mg/dl with mean phosphate binder pills/day of 4.4 to 5.2 pills over the 2-year follow-up. The % of patients with < 5.5 mg/dl increased from to 36.5% at baseline to 41.5-64.9% during follow-up. SO is an effective first-line PB therapy with least pill burden.
| BL | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | p-value | |
| PB pills/day | 0 | 4.4 | 4.8 | 5 | 5 | 5.1 | 5.1 | 5.2 | 5.1 | by design |
| sP (mg/dL) | 6.14 | 5.87 | 5.77 | 5.63 | 5.53 | 5.48 | 5.33 | 5.61 | 5.49 | <0.001 |
| % of pts with sP ≤ 5.5 mg/dL | 36.5 | 41.5 | 47.2 | 54.6 | 64.3 | 62.5 | 64.9 | 53.5 | 50 | <0.001 |
| Serum Calcium (mg/dL) | 9.12 | 9.1 | 9.17 | 9.12 | 9.06 | 9.04 | 9 | 9 | 9.01 | 0.15 |
| Intact PTH (pg/ml) | 435 | 475 | 433 | 471 | 529 | 514 | 476 | 502 | 513 | 0.39 |
| Single-pool Kt/V | 1.6 | 1.66 | 1.68 | 1.68 | 1.67 | 1.7 | 1.66 | 1.66 | 1.76 | 0.27 |
Funding
- Commercial Support –