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Kidney Week

Abstract: FR-PO636

Drug Therapy Choices for Acquired Distal Renal Tubular Acidosis by US Nephrologists and Rheumatologists

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical


  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Mccarthy, Robbie, Rare Insights LLC, Ardmore, Pennsylvania, United States
  • Robin, Ludovic, Advicenne S.A., Paris, France

Drivers of drug therapy choices for acquired distal renal tubular acidosis (dRTA) are not well understood. AdRTA, which is linked with Sjogren's disease, systemic lupus erythematosus (SLE), primary biliary cirrhosis (PBC) and autoimmune hepatitis, is often encountered by rheumatologists and nephrologists. To better understand the drug therapy approaches for AdRTA patients, a quantitative market research study was undertaken


Between March 25th–April 15th, 2019, an online survey was conducted with 30 nephrologists and 20 rheumatologists in the USA on the subject of dRTA, with a focus on AdRTA. All screened respondents had direct clinical experience of AdRTA patients


Sodium bicarbonate (SB) is the most commonly prescribed treatment for AdRTA, prescribed by 80% of nephrologists (Nph) and 56% of rheumatologists (Rhm), followed by sodium citrate (SC) and potassium citrate (PC). In potassium depleted patients, however, PC is the most commonly prescribed agent (Nph 55%, Rhm 57%). The majority of Rhms and Nephs consider the Neph is the most likely to prescribe all of the available treatments (range: 56% Flomax to 78% PC). 67% of Nphs report high satisfaction with SB and 53% with PC, fewer than their Rhm colleagues (high satisfaction: SB-90%, PC-100%). However, 70% of Nphs and 40% of Rhms indicate treatments for AdRTA are sub-optimal and only 60% of Nphs and 40% of Rhms considered the available treatments effective and easily accessible. Many nephrologists expressed that:“More effective therapies that are less burdensome to patients.” and “More new treatment options” are needed. [Figure]


Most nephrologists and rheumatologists have direct experience prescribing drug therapy for AdRTA with sodium bicarbonate being the most commonly prescribed treatment. However, while they express overall satisfaction with available treatments, many believe that they are sub-optimal, not effective or/and not easily accessible


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