Abstract: FR-PO147
Achievement of In-Range Serum Phosphorus (sP) and Decrease in Pill Burden Among Peritoneal Dialysis Patients Prescribed 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
- Parameswaran, Vidhya, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
- Ficociello, Linda, 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
Elevated levels of sP are associated with increased risk of cardiovascular and all-cause mortality in dialysis patients (pts). Phosphate binders (PB) are routinely prescribed for management of hyperphosphatemia. A cohort of peritoneal dialysis (PD) pts prescribed the PB sucroferric oxyhydroxide (SFO) as part of routine care was analyzed for changes in sP and PB pill burden over 12 months.
Methods
De-identified clinical data was extracted from electronic health records of a large dialysis organization (LDO; DaVita Inc) and prescription data extracted from the LDO’s pharmacy service. Adult PD pts who received 1 year of SFO monotherapy prescriptions between 5/1/2014 and 9/30/2018 were included in this retrospective database 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=82) had a mean BMI of 29 ± 28 kg/m2 and dialysis vintage of 41 ± 29 months. 55% of pts were male and 51% had diabetes. At BL, 35 pts had no PB prescriptions recorded in the pharmacy and the remaining pts were prescribed sevelamer (68%), calcium acetate (17%), lanthanum (8.5%), or switched between PB (6.4%). The table describes changes in laboratory measurements and PB pill burden. The % of patients achieving sP < 5.5 mg/dl increased from 25.6% at BL to 34.2-41.5% during SFO. This was accomplished with fewer PB pills/day (8.6 at BL vs 4.5-5.5 SFO pills/day). Pts with sP ≤ 5.5 mg/dL during SFO had a mean sP of 4.69 mg/dL.
Conclusion
PD pts from an LDO prescribed SFO as part of routine care, experienced significant reductions in sP along with a >40% reduction in PB pills/day and increase in % of patients with sP ≤5.5 mg/dl.
| BL | Q1 | Q2 | Q3 | Q4 | p-value | |
| PB pill burden (pills/day) | 8.6 | 4.5** | 4.9** | 5.3** | 5.5** | <0.001 |
| Serum phosphorus (mg/dL) | 6.63 | 6.21** | 6.07** | 6.21** | 6.23** | <0.001 |
| Patients with sP ≤ 5.5 mg/dL (%) | 25.6 | 34.2 | 41.5** | 35.4* | 35.4* | 0.027 |
| Patients with sP ≤ 4.5 mg/dL (%) | 3.7 | 13.4* | 13.4* | 7.3 | 14.6* | 0.019 |
| Serum calcium (mg/dL) | 8.94 | 8.87 | 8.81* | 8.82 | 8.76* | 0.02 |
| Intact PTH (pg/mL) | 621 | 604 | 587 | 639 | 614 | 0.71 |
* p<0.05; ** p<0.001
Funding
- Commercial Support –