Kidney Week

Abstract: TH-PO1194

Real-World Effectiveness of Patiromer among Hemodialysis (HD) Patients: 1-Year Follow-Up on a Retrospective Cohort

Session Information

• Late-Breaking Science Posters
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid, Electrolytes, and Acid-Base Disorders

• 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

• Zhou, Meijiao, Fresenius Medical Care, Waltham, Massachusetts, United States

Meijiao Zhou, MS, PhD, MPH

• Ruessmann, Despina, CSL Vifor Pharma Group, Glattbrugg, Switzerland

Despina Ruessmann, DrMed

• Ficociello, Linda, Fresenius Medical Care, Waltham, Massachusetts, United States

Linda Ficociello, PhD

• Gil Mir, Maria, Fresenius Medical Care, Bad Homburg, Germany

Maria Gil Mir, PhD

• Arens, Hans-Juergen, Fresenius Medical Care, Bad Homburg, Germany

Hans-Juergen Arens, PhD

• Anger, Michael S., Fresenius Medical Care, Waltham, Massachusetts, United States

Michael S. Anger, MD, FASN

Background

Patiromer (PAT) is a sodium-free, non-absorbed, calcium-based potassium (K⁺) binding polymer indicated for treating hyperkalemia. This study aimed to describe PAT utilization and evaluate the changes in serum K⁺ (sK) before and after PAT prescription in hemodialysis (HD) patients (pts) over a one-year follow-up period.

Methods

Adult Fresenius Kidney Care HD pts first prescribed PAT monotherapy between 1/2016- 12/2022 were included in the analysis. Eligible pts were on thrice-weekly HD for at least 90 days at the start of PAT and had available sK lab values in the 91 days prior to PAT initiation (baseline; bl; -3M to -1M) and during one year of PAT treatment (follow up; fup; Q1 to Q4; M1 to M12). Changes in lab measurements and prescribed dialysate were compared between bl and fup.

Results

At bl, pts (n=10854) had mean age of 60 years, HD vintage 58 months, 42% were female, 67% had diabetes, 20% had congestive heart failure, and 92% were not on K⁺ binders.
As shown in the figure, sK increased from 5.41 to 5.76 mEq/L before PAT initiation and decreased to 5.34- 5.21 mEq/L after PAT initiation. % of pts with sK<5.5 mEq/L nearly doubled from bl to Q4. Most pts initiated PAT at 8.4 g (91%) once daily (56%). Over fup, the average PAT dosage was one 8.4 g packet per day. Serum calcium was 8.93 mg/dL at bl and 8.96 mg/dL at Q4; serum sodium was 136.8 and 137.0 mEq/L at bl and Q4, respectively. % pts with calcium-phosphate product <4.4 mmol²/L² increased from 58.7% at bl to 63% at Q4. Dialysate calcium and sodium remained stable during the study period. % of pts prescribed one or more treatments with 1 mEq/L K⁺ bath decreased from 17.1% at bl to 11.0% at Q4.

Conclusion

Maintenance HD pts prescribed PAT experienced reductions in sK that were maintained over a year-long fup. % pts achieving sK<5.5 mEq/L nearly doubled from 35.5% at bl to 70.1% at Q4.

Funding

• Commercial Support – CSL Vifor