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Kidney Week

Abstract: PO0370

Hospital Admission Rates Among Hemodialysis Patients with Persistent Hyperphosphatemia Who Were Prescribed Changes in Phosphate Binder Treatment: A Retrospective Analysis of Real-World Data

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, 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
  • Anger, Michael S., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Phosphate binders (PB) may have different formulations, potency, and pill burden, however, there is limited data on hard outcomes to support decisions in PB therapy. The goal of this retrospective analysis is to determine the rate of all-cause hospital admissions of patients who, at baseline, remained hyperphosphatemic despite treatment with sevelamer carbonate (SC) and had prescriptions to either (1) switch to monotherapy sucroferric oxyhydroxide (SO) or (2) switched to Non-SO binders [Calcium Acetate, Lanthanum Carbonate, or Ferric Citrate] or added one of these PBs to SC therapy.

Methods

Deidentified clinical and prescription data were retrospectively extracted from the Fresenius Kidney Care data warehouse and pharmacy records. All prescription changes were the result of routine clinical care. We aimed to control for selection bias by using Inverse Probability of Treatment Weighting (IPTW). This method was chosen due to its ability to balance baseline characteristics between the two groups and maintain adequate sample size.

Results

We identified 1,076 patients with baseline hyperphosphatemia despite SC prescription who switched PB therapy, including 319 patients with SO therapy and 757 patients with Non-SO therapy. Patients switched to SO had 27 fewer hospital admissions per 100 patient-years compared to patients with Non-SO therapy (Table 1)

Conclusion

In a retrospective database analysis of hemodialysis patients previously treated with sevelamer carbonate and switched to SO or Non-SO phosphate binder therapy, patients switched to SO monotherapy had a lower rate of hospital admissions than patients switched to other, non-SO phosphate binders

 Incidence Rate per 100-PY
[95% CI]
Incidence Rate Ratio
[95% CI]
Incidence Rate Difference per 100-PY
[95% CI]
P
SO (319 pts)152.7
[147.0, 168.0]
0.849
[0.792, 0.904]
–27.1
[-41.3, -13.4]
0.002
Non-SO (757 pts)179.8
[170.2, 189.4]

Variables included in the Poisson regression model: HD vintage, congestive heart failure status, serum phosphorus and categories, iPTH and categories, (iPTH)2

Funding

  • Commercial Support