Abstract: PO0998
Effect of Velphoro on Serum Phosphate and Albumin in Peritoneal Dialysis Patients
Session Information
- Peritoneal Dialysis
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Perez, Luis M., University of Colorado, Denver, Colorado, United States
- You, Zhiying, University of Colorado, Denver, Colorado, United States
- Kendrick, Jessica B., University of Colorado, Denver, Colorado, United States
- Teitelbaum, Isaac, University of Colorado, Denver, Colorado, United States
Background
Hyperphosphatemia is common in patients on peritoneal dialysis (PD). Restricting phosphorus in the diet often leads to a decrease in protein intake, which may result in hypoalbuminemia. Hypoalbuminemia is associated with an increased risk of morbidity and mortality in PD patients. In observational studies, sucroferric oxyhydroxide (SO), an iron-based phosphate binder, was associated with improved phosphate control and higher serum albumin in hemodialysis patients. Whether SO improves phosphate control and nutritional status in PD patients is unknown.
Methods
We performed a prospective, open-label, 6-month, pilot study of 17 adult PD patients from the Denver Metro Area. Patients had to use automated peritoneal dialysis for at least 3 months, have a serum albumin ≤ 3.8 g/dL, and have serum phosphate ≥ 5.5 mg/dL or ≤5.5 mg/dL on a binder other than SO. Patients currently on phosphate binders underwent a 2-week washout period. Participants were started on SO at a dose of 1 tablet daily with meals. Serum phosphate was checked monthly and the dose of SO was titrated to a goal serum phosphate of < 5.5 mg/dL. The primary outcome was change in serum phosphate and serum albumin over 6 months.
Results
The mean (SD) age and dialysis vintage was 55 ± 13 years and 3.8 ± 2.7 years, respectively. The majority of patients were male (65%), white (82.4%) and non-Hispanic (64.7%). 88% of patients were on a phosphate binder at baseline and the majority were on sevelamer (73%). Twelve patients completed the study. Two patients withdrew due to side effects (diarrhea), 1 patient changed to hemodialysis and 2 patients died (unrelated to the study). Mild diarrhea and change in stool color were the most frequently reported side effects. Results are shown in Table 1. Serum phosphate decreased significantly from baseline but there was no significant change in serum albumin. Phosphate binder pill burden significantly decreased
Conclusion
Serum phosphate decreased significantly with fewer phosphate binder pills/day after switching to SO. There was no change in serum albumin.
| Prior to washout | Baseline | Month 3 | Month 6 | P-value | |
| Phosphate mg/dL | 6.72 ± 1.9 | 7.47 ± 1.76 | 5.63 ± 0.88 | 5.65 ± 1.81 | 0.001 |
| Albumin g/L | 3.51 ± 0.32 | 3.49 ± 0.37 | 3.58 ± 0.27 | 3.52 ± 0.28 | 0.46 |
| PTH pg/mL | 414 (143-613) | 415 (292-630) | 377 (128-504) | 379 (237-540) | 0.96 |
| Phosphate binders (pills/day) | 11.0 (9.0-12) | 4.0 (3-5.50) | 0.003 |
Funding
- Commercial Support – Fresenius Renal Therapies