FP619LONG-TERM SAFETY AND EFFICACY OF IRON-BASED PHOSPHATE BINDERS, FERRIC CITRATE HYDRATE VERSUS SUCROFERRIC OXYHYDROXIDE, ON HYPERPHOSPHATEMIA IN CHRONIC HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims:The purpose ofthis study was to investigate the clinical efficacy and safety of new phosphate (P) binders, ferric citrate hydrate versus sucro‐ferric oxyhydroxide, after switching from previously prescribed P binders on controlling serum P levels and relieving anemia in chronic hemodialysis patients. Methods: Subjects: Among 66 hemodialysis patients for at least12 months between June 2016 and July 2017, 42 patients (Male 28, Female 14, mean age 68.2 years, DM 19 patients) who met the entry criteria were enrolled in this study.Methods: We divided at random from 2 Groups,and had treated with ferric citrate hydrate (F group) and sucro‐ferric oxyhydroxide (S group) on hyperphosphatemia, while ferric citrate hydrate 1500mg/day versus sucroferric oxyhydroxide 750mg/day were administrated at the time of switch and followed up for 12 months, and investigated P metabolism, iron kinetic markers and erythropoietin (ESA) dose. Results: 1)SerumPlevels were shown 5 mg/dL inboth groups during treatment. There were no significant changes in serum calcium, however, intact parathyroid hormone (I‐PTH) levels significantly increased at 9 months in F group. 2) The average hemoglobin (Hb) levels were shown 11 g/dL in both groups. There were significant ascensions in both serum iron and average transferrin saturation (TSAT) after 12 months in F group (p<0.05), furthermore, there were finally significant elevations in the changes of serum ferritin levels in both groups. 3) ESA doses respectively increased 4500 units/week in both groups, and showed a significant changes at statistical analysis in F group.4) In our study, 30% patients in each groups dropped out by adverse effects during the treatment. The frequency of gastrointestinal side effects showed 12% in F group and 24% in S group respectively. Conclusions: The treatment of Iron‐based phosphate binders can beaneffective and safety drugs on both hyperphosphatemia and anemia in chronic hemodialysis patients. We must examine the necessity of administration with Iron‐based phosphate binders, not only in relation of both changes of I‐PTH and the iron kinetics, but also in term of adverse effects of the characteristics of individual patients.