PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS
Hyperphosphataemia is associated with increased all-cause mortality in patients with chronic kidney disease (CKD), but serum phosphate (P) levels can be managed by dialysis, diet and the use of P binders. Serum P data were obtained retrospectively from a US dialysis provider for the 9 months followi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2012-06-01
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| Series: | Kidney Research and Clinical Practice |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211913212006559 |
| _version_ | 1819058781212901376 |
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| author | Kimberly Farrand J Brian Copley Jamie Heise Moshe Fridman Michael Keith Arthur Silverberg |
| author_facet | Kimberly Farrand J Brian Copley Jamie Heise Moshe Fridman Michael Keith Arthur Silverberg |
| author_sort | Kimberly Farrand |
| collection | DOAJ |
| description | Hyperphosphataemia is associated with increased all-cause mortality in patients with chronic kidney disease (CKD), but serum phosphate (P) levels can be managed by dialysis, diet and the use of P binders. Serum P data were obtained retrospectively from a US dialysis provider for the 9 months following initiation of haemodialysis (HD) in CKD patients, who were then grouped according to the variations in their serum P. Group baseline characteristics and changes in P binder use over time were described.
Variations in average monthly serum P values from months 4 to 9 were classified as either consistently in the target range (CT, 3.5–5.5 mg/dL), consistently low (CL, < 3.5 mg/dL), consistently high (CH, > 5.5 mg/dL), or varying between the low and target (LT), target and high (TH) or the low and high ranges (LH). For each group, baseline characteristics and changes in P binder use during the study were compared with CT (the reference group) to identify differences.
In total, 47742 eligible patients were allocated to the six groups: CT, 7301; CL, 131; CH, 5001; LT, 6469; TH, 24469; LH, 4371. CH, TH, and LH were significantly younger than CT, with fewer comorbidities, higher incidence of elevated parathyroid hormone (PTH) and higher mean serum P; CH and TH also had higher levels of P binder use. CL and LT were older, with more comorbidities, lower PTH levels and lower levels of P binder use than CT. Overall, comparing months 8–9 with baseline (months 1–3), more patients received P binder therapy (51.7 vs 35.0%), on a larger percentage of days (50.0 vs 30.9%), but with little change in mean serum P (5.3 vs 5.2 mg/dL). By group, mean serum P increased numerically in CH (7.5 vs 6.6 mg/dL) and TH (5.6 vs 5.4 mg/dL) but decreased in other groups.
Serum P can be difficult to control following initiation of HD. Patients with elevated serum P were younger, and most had higher P binder use than the reference group. Overall, binder use was lower than in other studies of HD patients. Dietary education and higher doses of the most effective P binders may be needed to improve P management. |
| first_indexed | 2024-12-21T14:00:39Z |
| format | Article |
| id | doaj.art-e21dcfca406a4b9d8a6fb83a55eb5ed7 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 |
| language | English |
| last_indexed | 2024-12-21T14:00:39Z |
| publishDate | 2012-06-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-e21dcfca406a4b9d8a6fb83a55eb5ed72022-12-21T19:01:23ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322012-06-01312A9210.1016/j.krcp.2012.04.622PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSISKimberly Farrand0J Brian Copley1Jamie Heise2Moshe Fridman3Michael Keith4Arthur Silverberg5Shire Pharmaceuticals, Wayne, PA, USA.Shire Pharmaceuticals, Wayne, PA, USA.Shire Pharmaceuticals, Wayne, PA, USA.AMF Consulting, Los Angeles, CA, USA.Shire Pharmaceuticals, Wayne, PA, USA.Shire Pharmaceuticals, Wayne, PA, USA.Hyperphosphataemia is associated with increased all-cause mortality in patients with chronic kidney disease (CKD), but serum phosphate (P) levels can be managed by dialysis, diet and the use of P binders. Serum P data were obtained retrospectively from a US dialysis provider for the 9 months following initiation of haemodialysis (HD) in CKD patients, who were then grouped according to the variations in their serum P. Group baseline characteristics and changes in P binder use over time were described. Variations in average monthly serum P values from months 4 to 9 were classified as either consistently in the target range (CT, 3.5–5.5 mg/dL), consistently low (CL, < 3.5 mg/dL), consistently high (CH, > 5.5 mg/dL), or varying between the low and target (LT), target and high (TH) or the low and high ranges (LH). For each group, baseline characteristics and changes in P binder use during the study were compared with CT (the reference group) to identify differences. In total, 47742 eligible patients were allocated to the six groups: CT, 7301; CL, 131; CH, 5001; LT, 6469; TH, 24469; LH, 4371. CH, TH, and LH were significantly younger than CT, with fewer comorbidities, higher incidence of elevated parathyroid hormone (PTH) and higher mean serum P; CH and TH also had higher levels of P binder use. CL and LT were older, with more comorbidities, lower PTH levels and lower levels of P binder use than CT. Overall, comparing months 8–9 with baseline (months 1–3), more patients received P binder therapy (51.7 vs 35.0%), on a larger percentage of days (50.0 vs 30.9%), but with little change in mean serum P (5.3 vs 5.2 mg/dL). By group, mean serum P increased numerically in CH (7.5 vs 6.6 mg/dL) and TH (5.6 vs 5.4 mg/dL) but decreased in other groups. Serum P can be difficult to control following initiation of HD. Patients with elevated serum P were younger, and most had higher P binder use than the reference group. Overall, binder use was lower than in other studies of HD patients. Dietary education and higher doses of the most effective P binders may be needed to improve P management.http://www.sciencedirect.com/science/article/pii/S2211913212006559 |
| spellingShingle | Kimberly Farrand J Brian Copley Jamie Heise Moshe Fridman Michael Keith Arthur Silverberg PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS Kidney Research and Clinical Practice |
| title | PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS |
| title_full | PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS |
| title_fullStr | PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS |
| title_full_unstemmed | PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS |
| title_short | PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS |
| title_sort | phosphate binder therapy and serum phosphate control following initiation of haemodialysis |
| url | http://www.sciencedirect.com/science/article/pii/S2211913212006559 |
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