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Kidney Week

Abstract: PO1213

Use of Triferic and Outcomes of Hemodialysis-Dependent Patients: Initial Analysis Using 2016-2017 USRDS

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Zhang, Yi, MTPPI, Bethesda, Maryland, United States
  • Hoffman, Marc L., Rockwell Medical Inc, Wixom, Michigan, United States
  • Gupta, Ajay, Rockwell Medical Inc, Wixom, Michigan, United States

Use of iron oxide nanoparticles (IONP) to replace iron losses in CKD-HD patients has been associated with increased risk of infections. We have examined patient outcomes with ferric pyrophosphate citrate (FPC; Triferic®), a novel iron compound delivered via the hemodialysate, relative to the general U.S. hemodialysis patient population receiving IONPs in US Renal Data System (USRDS). A single outpatient free-standing hemodialysis center with ~57 adult CKD-HD patients between 2016 and 2017, converted to FPC in January 2017. Unadjusted all-cause and infection related hospitalizations and mortality were examined pre-FPC and post-FPC and compared with the general USRDS data during the same period.


USRS methods were utilized for calculation of the crude hospitalization and mortality rates. For each calendar study year, the period at risk begins at the later date of either January 1 or day 91 of ESRD, and censoring occurs at death, or December 31.


Consistent with findings from USRDS, unadjusted all-cause hospital and mortality rates for the general ESRD population in 2016 were 2.12 hospital admissions, 16.0 hospital days, 0.35 infection-related admissions, 3.05 infectious hospitalization days per patient year, and 164 deaths per 1,000 patient years. Notably, patients in 2017 exhibited similar rates compared to 2016. In contrast, patients treated in the facility using Triferic experienced a reduction in both mortality and infection-related hospitalizations. Specifically, mortality rates reduced 58% from 101 per 1,000 patient-years in 2016 to 42 in 2017; infectious hospital admission reduced 73% from 0.49 admissions per patient-year in 2016 to 0.13 admissions in 2017. Furthermore, infection-related hospital days reduced 82% from 3.86 days per patient-year in 2016 to 0.71 in 2017.


This observational cohort study suggests that use of ferric pyrophosphate citrate as an iron replacement therapy is associated with reduction in all cause and infection-related hospitalizations and mortality. Further analysis is needed to confirm the findings from this initial analysis after controlling a variety of patient case-mix factors and dialysis center characteristics with a larger sample size.


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