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Abstract: TH-PO142

Management of Serum Phosphorus over a Six-Month Follow-Up in Home Hemodialysis Patients Prescribed Sucroferric Oxyhydroxide as Part of Routine Clinical Care

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Zhou, Meijiao, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
  • Anger, Michael S., Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
  • Kwoh, Christopher, The Kidney Institute, Houston, Texas, United States
Background

With the growing use of home hemodialysis (HHD) and the increasing trend of physicians prescribing sucroferric oxyhydroxide (SO) in recent years, this real-world data analysis examines the serum phosphorus (sP) management with SO in HHD patients (pts) over 6 months.

Methods

Eligible HHD pts (n=713) were adults from Fresenius Kidney Care first prescribed SO monotherapy during 9/2016-12/2020 and had sP measured the month (mo) before SO start (-1M). sP was assessed up to 3 months (mos) before (baseline, BL; -3M to -1M) and 6 mos following SO initiation (follow up, FU; M1 to M6). Pts were censored from the analysis upon transplant (n=53), discharge (n=94), and discontinuation of SO (n=177 including n=80 prescribed another phosphate binder (PB) after SO stop). Comparisons of parameters were made between -1M and other mos.

Results

Pts (n=713) were on average 53 years, 42 mos vintage, and 34% female. The PB distribution in pts with PB recorded at BL (78%): sevelamer 51%, calcium acetate 21%, lanthanum carbonate 3%, ferric citrate 8% and >1 PB 16%. sP increased over the BL, from 6.1 mg/dL at -3M to 6.6 mg/dL at -1M but declined after SO start (5.9 to 6.1 mg/dL during FU; p<.0001). Accordingly, the % of pts with sP≤ 5.5 mg/dL increased from 22% at -1M to 43% at M6 (p<.0001), and the % with sP≤ 4.5 mg/dL increased from 9% at -1M to 19% at M6 (p<.0001), with pill burden decreasing from 8.3 to 4.7 pills/day (p<.0001). Serum calcium showed a significant decline from -1M to M6 (9.15 to 9.03 mg/dL, p<.001). No significant changes (p=0.3) were observed in iPTH following SO prescription (518 pg/mL at -1M and 525 to 553 pg/mL during FU).

Conclusion

HHD pts prescribed SO as part of routine clinical care experienced improvements in sP control and reductions in PB pill burden over a 6-month FU, compared to BL.

Funding

  • Commercial Support – Fresenius Medical Care