Abstract: PO0541
Serum Phosphorus (sP) and Pill Burden Among Hemodialysis (HD) Patients Prescribed Sucroferric Oxyhydroxide (SO): One-Year Follow-Up on a Contemporary Cohort
Session Information
- Bone and Mineral Metabolism: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Kendrick, Jessica B., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Zhou, Meijiao, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Ficociello, Linda, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Parameswaran, Vidhya, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Mullon, Claudy, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Anger, Michael S., Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Coyne, Daniel W., Washington University School of Medicine, St. Louis, Missouri, United States
Background
A previous real-world analysis included HD patients (pts) prescribed SO during 2014-2015 followed for 1 year. Improvements in sP were observed along with fewer phosphate binder (PB) pills/day after pts switched from their previous PB to SO (2014 Cohort, Kendrick). To examine how PB prescription (Rx) patterns have changed over time, the present study compares the long-term effectiveness of SO in a contemporary cohort (prescribed SO in 2018-2019; 2018 Cohort) with 2014 Cohort results.
Methods
Adult Fresenius Kidney Care HD pts first prescribed SO monotherapy during 5/2018- 5/2019 as part of routine care and followed for one year were included. All pts were on a non-SO PB during a 91-day baseline (BL) before SO Rx. Mean PB pills/day and labs were compared for BL and SO follow-up (divided into 4 consecutive 91-day intervals; Q1-Q4) using mixed-effects linear regression and Cochran's Q test. These results were compared with findings from the 2014 Cohort.
Results
Compared to the 2014 Cohort (n=530), the 2018 Cohort (n=1793) was older (57 vs 55 yrs) with shorter HD vintage (34 vs 45 months), more likely prescribed calcium acetate (36 vs 28%) and ferric citrate (6% vs 0) and less likely prescribed sevelamer (47 vs 60%). The 2018 Cohort had better BL sP control; both cohorts showed reductions in sP and PB pills/day after SO conversion. During SO FU, iPTH decreased in the 2018 Cohort.
Conclusion
Despite different pt characteristics and treatment patterns in the 2014 and 2018 cohorts, HD pts from both cohorts had improvements in sP and % pts achieving sP ≤ 5.5 mg/dL or sP ≤ 4.5 mg/dL with fewer PB pills/day after SO conversion.
| Cohort | BL: -Q1 | Q1 | Q2 | Q3 | Q4 | P- value | |
| sP, mg/dL | 2018 | 6.38 | 6.10** | 5.88** | 5.88** | 5.93** | <.001 |
| 2014 | 6.82 | 6.54** | 6.37** | 6.25** | 6.19** | <.001 | |
| sP≤ 5.5 mg/dL, % | 2018 | 27.0 | 37.8** | 45.1** | 44.7** | 44.0** | <.001 |
| 2014 | 17.7 | 24.5** | 30.5** | 36.4** | 36.0** | <.001 | |
| sP≤ 4.5 mg/dL, % | 2018 | 8.4 | 12.7** | 16.8** | 17.4** | 17.0** | <.001 |
| 2014 | 4.7 | 6.6 | 11.6** | 12.1** | 13.7** | <.001 | |
| PB, pills/day | 2018 | 7.7 | 4.4** | 4.6** | 4.8** | 4.9** | <.001 |
| 2014 | 8.5 | 4.0** | 4.1** | 4.2** | 4.3** | <.001 | |
| iPTH, pg/ml | 2018 | 564 | 560 | 558 | 545* | 528** | <.001 |
| 2014 | 611 | 627 | 622 | 636 | 643* | 0.16 | |
| Corrected Calcium, mg/dL | 2018 | 9.64 | 9.61* | 9.58** | 9.53** | 9.52** | <.001 |
| 2014 | 9.25 | 9.21* | 9.16** | 9.16** | 9.10** | <.001 |
*P<0.05; **P<.001 (vs. BL)
Funding
- Commercial Support – Fresenius Medical Care Renal Therapies Group