A 6-Month clinical practice pilot study of sucroferric oxyhydroxide on nutritional status in patients on peritoneal dialysis

Luis Perez, Zhiying You, Isaac Teitelbaum, Emily S Andrews, Rachael Reddin, Lorena Ramirez-Renteria, Gabriela Wilson, Jessica Kendrick, Luis Perez, Zhiying You, Isaac Teitelbaum, Emily S Andrews, Rachael Reddin, Lorena Ramirez-Renteria, Gabriela Wilson, Jessica Kendrick

Abstract

Background: Hyperphosphatemia is common in patients on peritoneal dialysis (PD). Restricting dietary phosphorus often leads to a decrease in protein intake, which may result in hypoalbuminemia. The high pill burden of phosphate binders may also contribute to compromised appetite and dietary intake. Hypoalbuminemia is associated with an increased risk of morbidity and mortality in PD patients. The goal of this study was to determine if sucroferric oxyhydroxide improves albumin and self-reported measures of appetite in PD patients.

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 ≥ 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. SO was titrated to a goal serum phosphate of < 5.5 mg/dL. The primary outcome was change in serum phosphate, albumin, and phosphorus-attuned albumin (defined as albumin divided by phosphorus) over 6 months.

Results: The mean (SD) age and dialysis vintage was 55 ± 13 years and 3.8 ± 2.7 years, respectively. Participants' serum phosphate significantly decreased with fewer phosphate binder pills/day after switching to SO. There was no change in serum albumin, appetite, or dietary intake. However, participants had significant improvements in phosphorus-attuned albumin.

Conclusion: The transition to SO improved phosphorus control, phosphorus-attuned albumin, and pill burden. There were no significant changes in self-reported appetite or dietary intake during the study. These findings suggest that PD patients maintained nutritional status with SO therapy.

Trial registration: First registered at ClinicalTrials.gov ( NCT04046263 ) on 06/08/2019.

Keywords: Albumin; Appetite; Binders; Dialysis; Peritoneal; Phosphorus.

Conflict of interest statement

JK has served as an advisory board member for Fresenius Medical Care Renal Therapies Group. All other authors have no competing interests to declare.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Changes in Study Clinical Values. A Change in Serum Phosphorus. B Change in Serum Albumin. C Change in Phosphorus Attuned Albumin. BL, baseline visit; M3, month-3 visit; M6, month-6 visit. * P value < 0.05

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Source: PubMed

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