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Abstract: SA-PO907

Sevelamer vs. Cardiopulmonary Bypass on Renal Replacement Treatments, Cardiovascular Events, and Mortality in Non-Dialysis Dependent (NDD)-CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Li, Ping, Chinese PLA General Hospital, State Key Laboratory of Kidney Disease, Beijing, China
  • Sun, Xuefeng, Chinese PLA General Hospital, State Key Laboratory of Kidney Disease, Beijing, China
  • Chen, Xiangmei, Chinese PLA General Hospital, State Key Laboratory of Kidney Disease, Beijing, China
  • Cai, Guangyan, Chinese PLA General Hospital, State Key Laboratory of Kidney Disease, Beijing, China
Background

Hyperphosphatemia is a key uremic toxin associated with adverse outcomes in patients with CKD. Sevelamer, a widely used non-calcium-based phosphate binder, has been proven to provide extra benefits. However, there is limited evidence on the long-term benefit of Sevelamer on renal and cardiovascular outcomes in NDD-CKD patients.

Methods

We used Optum Clinformatics® administrative claims database (May 1, 2000-November 30, 2021) as the data source in this study. We used 1:1 Propensity score matching (PSM) techniques to improve the comparability between Sevelamer group and CPB group. The primary endpoint is renal replacement therapy (RRT). The secondary endpoints include major adverse cardiovascular events (MACE, defined as a composite of non-fatal MI, non-fatal stroke, or all-cause mortality), MACE plus (defined as a composite of MACE, unstable angina pectoris, and congenital heart failure), and all-cause mortality. We also examined the incidence of hemorrhage stroke and fracture as safety endpoints.

Results

In total, 9,047 patients were included (Sevelamer group: n=6,644; CPB group: n=2,403). After PSM, 2399 patients remained in each group. During 3 years follow-up, patients in Sevelamer group experienced significantly lower incidence of RRT compared with patients in CPB group [1,560 (65.0%) in Sevelamer group vs. 1,687 (70.3%) in CPB group, HR, 0.84 (95%CI: 0.79-0.91), P<0.0001], MACE [1,077(44.9%) in Sevelamer group vs. 1,217 (50.7%) in CPB group, HR: 0.91 (95%CI: 0.84-0.99), P=0.0249] and MACE plus [1,244 (51.9%) in Sevelamer group vs. 1,419 (59.1%) in CPB group, HR: 0.88 (95%CI: 0.81-0.95),P=0.0009]. Patients in both groups experienced similar incidence of all-cause death, hemorrhage stroke and bone fracture.

Conclusion

In this PSM cohort study, Sevelamer showed a lower incidence of RRT, MACE, and MACE plus compared with CPB in NDD-CKD patients with hyperphosphatemia.
Acknowledgement: The access to Optum Clinformatics® administrative claims database and data analysis were supported by Sanofi Pharmaceuticals, In according to Good Publication Practice guidelines. The sponsor was involved in the study design and analysis of data and data checking of information provided in the abstract. The authors were responsible for all content and editorial decisions and received no honoraria related to the development of this publication.

Funding

  • Commercial Support –