Kidney Week

Abstract: TH-PO242

Symptom Burden with Calcium Carbonate Compared to Sevelamer in Haemodialysis Patients

Session Information

• Hemodialysis and Frequent Dialysis - II
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Pan, Fei Fei Mary, The Royal Melbourne Hospital, Parkville, Victoria, Australia

Fei Fei Mary Pan,

• Toussaint, Nigel David, The Royal Melbourne Hospital, Parkville, Victoria, Australia

Nigel David Toussaint,

• Moodie, Jo-anne M., The Royal Melbourne Hospital, Parkville, Victoria, Australia

Jo-anne M. Moodie,

• Isac, Tessy, Melbourne health, Melbourne, New South Wales, Australia

Tessy Isac,

• Smith, Edward R., The Royal Melbourne Hospital, Parkville, Victoria, Australia

Edward R. Smith,

• Champion de Crespigny, Paul J., The Royal Melbourne Hospital, Parkville, Victoria, Australia

Paul J. Champion de Crespigny,

• Hewitson, Timothy D., The Royal Melbourne Hospital, Parkville, Victoria, Australia

Timothy D. Hewitson,

• Holt, Stephen G., The Royal Melbourne Hospital, Parkville, Victoria, Australia

Stephen G. Holt,

Background

Patients with CKD frequently experience a considerable symptom burden which interferes with quality of life. Gastrointestinal tract (GIT) symptoms, including nausea, vomiting, constipation and diarrhoea, affect 10-40% of CKD patients. Medications, including phosphate binders (PB), often contribute to this symptom burden. We compared symptoms on the calcium-based phosphate binder, calcium carbonate (CC) therapy with those on sevelamer in a clinical trial.

Methods

Prevalent haemodialysis (HD) patients were recruited into a randomised study (n=37). Total study duration was 37 weeks, including 1 week of PB ‘washout’. Participants were randomised to either i) 36 weeks of CC therapy or ii) 12 weeks of CC, followed by 24 weeks of sevelamer therapy. Patient symptoms were assessed with the Palliative Care Outcome Scale-Renal Version (POS) and analysed according to total scores and individual scores for specific GIT symptoms.

Results

26 participants completed the study, and were analysed according to intention-to-treat analysis. 10 participants were randomised to the CC only arm, whilst 16 to the CC/sevelamer arm. There were no statistically significant differences in baseline demographics or co-morbidities between the groups. At baseline, median total POS scores were 10 (interquartile range: [IQR] 7-14) in the CC only arm vs. 13 (IQR 3-19) in the CC/sevelamer arm. At study completion, median POS scores were 12 (IQR 7-13) in the CC only arm, vs 8 (IQR 2-13) in the CC/sevelamer arm, with no statistically significant differences between groups at any timepoint. With regards to GIT symptoms, the proportion of patients experiencing improvement in nausea from baseline to study end were 30% and 44% in the CC only and CC/sevelamer arms respectively, and for vomiting, 10% vs 25% experienced improvement in the respective groups. 20% of CC only patients had more severe constipation at study end vs 31% in the CC/sevelamer group; and for diarrhoea, 30% of CC only vs 35% of CBPB/sevelamer patients reported increased symptoms. None of the changes in specific GIT symptoms were statistically significant.

Conclusion

Symptom burden of patients on HD did not change significantly with different PB therapy in our study, with similar changes in GIT symptoms over time comparing CC and sevelamer therapy.

Funding

• Commercial Support –