Abstract: INFO17-TH
Medication Burden Reduction with Tenapanor in Patients on Maintenance Hemodialysis with Hyperphosphatemia Receiving Different Baseline Phosphate Binders: A Multicenter Prospective Cohort Study
Session Information
- Informational Posters - 1
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- No subcategory defined
Authors
- Wang, Rong, Shandong Provincial Hospital, Jinan, Shandong, China
- Lv, Zhimei, Shandong Provincial Hospital, Jinan, Shandong, China
Description
Introduction
Hyperphosphatemia is a prevalent complication in maintenance hemodialysis (MHD) patients, associated with elevated cardiovascular risk and high medication burden from combined phosphate binder (PB) therapy. Tenapanor, a novel sodium-hydrogen exchanger 3 (NHE3) inhibitor, offers an alternative phosphate-lowering mechanism. However, evidence regarding its feasibility to reduce pill burden via monotherapy conversion in patients on different baseline PB regimens remains limited. This study aims to evaluate the medication reduction benefits, monotherapy switch feasibility, efficacy and safety of tenapanor in MHD patients with hyperphosphatemia, to provide evidence for individualized low-burden hyperphosphatemia management.
Methods
This multicenter, prospective cohort study will enroll 148 MHD patients with serum phosphorus > 5.5 mg/dL across 10 centers in China. Patients will be stratified into two cohorts during the 4-week screening phase (-4 weeks to Day 0): Cohort A (patients on single-agent PB therapy at baseline) and Cohort B (patients on combined therapy with ≥2 PBs at baseline). The study includes a 20-week treatment phase, with 8 scheduled visits at screening, baseline, Week 2, 4, 8, 12, 16 and 20. All blood samples will be collected pre-dialysis. Standardized dose adjustment, medication review and adverse event monitoring will be performed at each visit.
The primary endpoint is the proportion of patients achieving full conversion to tenapanor monotherapy at Week 20, with inter-cohort comparison. Full monotherapy conversion is defined as no use of any additional PBs for 4 consecutive weeks, with sustained serum phosphorus within the target range of 3.5–5.5 mg/dL.
Discussion
This is the first Chinese study specifically evaluating tenapanor's monotherapy conversion potential across different baseline PB burden levels. The findings will complement existing tenapanor clinical trial data by providing real-world evidence on pill burden reduction, a critical unmet need in hemodialysis patients with long-term polypharmacy. This study will also support individualized treatment strategies to improve treatment adherence and long-term outcomes in hyperphosphatemia management.