Naslov
Effects of sucroferric oxyhydroxide and sevelamer carbonate on chronic kidney disease–mineral bone disorder parameters in dialysis patients

Autori
Ketteler, Markus ; Sprague, Stuart M ; Covic, Adrian C ; Rastogi, Anjay ; Spinowitz, Bruce ; Rakov, Viatcheslav ; Walpen, Sebastian ; Floege, Jürgen

Izvornik
Nephrology Dialysis Transplantation (0931-0509) 34 (2018), 7; 1163-1170

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
hyperphosphataemia

Sažetak
Background Treatment of hyperphosphataemia is the primary goal of chronic kidney disease-mineral and bone disorder (CKD-MBD) management. This post hoc analysis of a randomized, Phase 3 study evaluated the effects of 1-year treatment with the phosphate binders sucroferric oxyhydroxide or sevelamer carbonate (sevelamer') on CKD-MBD indices among dialysis patients with hyperphosphataemia. Methods After a 2- to 4-week washout from previous phosphate binders, 1059 patients were randomized 2:1 to sucroferric oxyhydroxide 1.0-3.0g/day (n=710) or sevelamer 2.4-14.4g/day (n=349) for up to 24weeks. Eligible patients enrolled in a 28- week extension. This post hoc analysis was performed for patients who completed >= 1 year of continuous treatment (n=549). As the treatment groups showed similar CKD-MBD outcomes, the data were pooled for this analysis. Results Phosphate-binder therapy was associated with significant and sustained 30% reductions in serum phosphorus (P<0.001). Median intact fibroblast growth factor-23 (FGF-23) also significantly decreased (P<0.001) by 64% over 1year. Intact parathyroid hormone decreased significantly after 24weeks (P<0.001), but levels returned to near baseline values by Week 52 ; minimal changes in serum calcium were observed. Of the bone resorption markers evaluated, tartrate- resistant acid phosphatase 5b (TRAP5b) decreased significantly (P<0.001), whereas CTx increased transiently but returned to baseline levels by Week 52. The bone formation markers bone-specific alkaline phosphatase and osteocalcin both increased over 1year of treatment. Conclusions Overall, 1 year of sucroferric oxyhydroxide or sevelamer treatment significantly reduced serum FGF-23, which has been associated with clinical benefit in patients with CKD. The trend towards increased bone formation marker levels indicates a beneficial effect on bone metabolism.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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