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Abstract: PO0379

Changes in Serum Phosphorus and Pill Burden in Peritoneal Dialysis (PD) Patients Treated with Sucroferric Oxyhydroxide (SO) as Part of Routine Clinical Care: A Contemporary Cohort

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Kalantar-Zadeh, Kamyar, University of California Irvine, Orange, California, United States
  • Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Zhou, Meijiao, 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
Background

Previous real-world analyses of SO in PD patients (pts) included pts first prescribed SO within the first 2 years of SO availability in the US (2014 Cohort: Kalantar 2018). A more contemporary cohort of pts prescribed SO may have different patient characteristics or treatment patterns than earlier SO pts. The current retrospective study assessed changes in serum phosphorus (sP) and phosphate binder (PB) pill burden in PD pts recently and previously prescribed SO.

Methods

Included were adult Fresenius Kidney Care PD pts first prescribed SO monotherapy during 5/2018- 5/2019 with PB monotherapy during a 3-month baseline (BL), and sP measured the month before SO initiation (-M1) and ≥4 months of the 6-month follow-up (2108 Cohort). Means were calculated monthly (-M1, M1-M6) for PB pills/day and monthly labs and quarterly for iPTH using mixed-effects linear regression.

Results

At BL, the 2018 Cohort (n=201) included slightly older pts (52.3 vs 50.6 yrs) with shorter dialysis vintage (22 vs 29 months) and different BL PB: sevelamer (42 vs 63%), calcium acetate (35 vs 21%), lanthanum (3 vs 5%), ferric citrate (12 vs 0%), or switched PB (8 vs 11%) compared to 2014 cohort. Lower pill burden (7 vs 10) and sP (6.52 vs 6.59) at BL were observed in 2018 cohort. In the 2018 cohort, pts achieving sP≤5.5 mg/dL increased from 21.9% at -1M to 40.5-47.3% during follow-up and the pattern was similar in 2014 cohort (25.8% at -1 M to 35.3-44.4% at follow-up). Mean SO pills/day was higher (4.7) in 2018-2019 cohort than the 2014 cohort (4.3).

Conclusion

PD pts prescribed SO as part of routine care in 2018 and 2014 experienced significant reductions in sP, and PB pill burden, and an increase in pts with sP≤5.5mg/dL.

 -1M
(ref)
M1M2M3M4M5M6P-Valuea
Phosphate binder pills/day7.14.4**4.4**4.6**4.8**4.9**4.9**<0.001
Serum phosphorus (sP), mg/dL6.806.26**6.21**6.23**6.09**6.06**6.27**<0.001
Patients with sP ≤ 5.5 mg/dL, %21.941.4**41.7**40.5**47.3**42.3**41.1**<0.001
Serum calcium, mg/dL9.058.89*8.968.968.91*8.89*8.87**0.005
Intact PTH, pg/mL4835185170.08
Serum albumin, g/dL3.633.59*3.603.59*3.57*3.57*3.59*0.03
sP-attuned albumin, x 1030.570.63**0.63**0.62**0.64**0.64**0.61**<0.001

*P<0.05; **P<.001 (vs. ref); a P-Values from mixed-effects linear regression or Cochran's Q

Funding

  • Commercial Support