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Real-world management of hyperphosphataemia with sucroferric oxyhydroxide: the VELREAL multicentre study

Authors
  • Navarro-González, Juan F1, 2, 3, 4
  • Arenas, María Dolores5
  • Henríquez-Palop, Fernando6
  • Lloret, María Jesús7
  • Molina, Pablo8
  • Ríos Moreno, Francisco9
  • Macia-Lagier, María Asunción10
  • Espinel, Laura11
  • Sánchez, Emilio12
  • Lago, Mar13
  • Crespo, Antonio14
  • Bover, Jordi3, 7
  • 1 Servicio de Nefrología y Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Spain , (Spain)
  • 2 Instituto de Tecnologías Biomédicas, Universidad de La Laguna, Spain , (Spain)
  • 3 Red de Investigación Renal (REDINREN – RD16/0009), Instituto de Salud Carlos III, Spain , (Spain)
  • 4 ERA-EDTA Working Group on CKD-MBD, Italy , (Italy)
  • 5 Servicio de Nefrología, Hospital del Mar, Spain , (Spain)
  • 6 Centro de Diálisis Avericum Norte, Spain , (Spain)
  • 7 Servicio de Nefrología, Spain , (Spain)
  • 8 Servicio de Nefrología, Hospital Universitario Dr. Peset, Spain , (Spain)
  • 9 Centro Diálisis San Luciano, Spain , (Spain)
  • 10 Servicio de Nefrología, Hospital General de La Palma, Spain , (Spain)
  • 11 Servicio de Nefrología, Hospital Universitario de Getafe, Spain , (Spain)
  • 12 Servicio de Nefrología, Hospital Universitario de Cabueñes, Spain , (Spain)
  • 13 Servicio de Nefrología, Complejo Hospitalario Universitario Insular, Spain , (Spain)
  • 14 Servicio de Nefrología, Hospital Marina Baixa, Spain , (Spain)
Type
Published Article
Journal
Clinical Kidney Journal
Publisher
Oxford University Press
Publication Date
Feb 01, 2021
Volume
14
Issue
2
Pages
681–687
Identifiers
DOI: 10.1093/ckj/sfaa226
PMID: 33626111
PMCID: PMC7886585
Source
PubMed Central
Keywords
Disciplines
  • AcademicSubjects/MED00340
License
Unknown

Abstract

Background The efficacy and safety of sucroferric oxyhydroxide (SO) have been reported in clinical trials. However, real-life data are scarce. This study presents data on the use, efficacy and safety of SO in real clinical practice. Methods We performed a retrospective multicentre study, without any influence on the prescription decisions, that included 220 patients from 11 Spanish centres. Demographic, treatment, analytical and nutritional parameters and adherence, side effects and dropout rates were collected during 6 months. Results SO was initiated due to inadequate control of serum phosphate (P) in 70% of participants and in 24.5% to reduce the number of tablets. Monotherapy with SO increased from 44% to 74.1%, with a reduction in the average daily number of sachets/tablets from six to two. Serum P decreased by 20% (4.6 ± 1.2 versus 5.8 ± 1.3 mg/dL; P < 0.001), with a significant reduction in intact parathyroid hormone levels (P < 0.01). The percentage of patients with adequate serum P control at threshold levels of 5 and 4.5 mg/dL increased by 45.4% and 35.9%, respectively. Serum ferritin was not modified, while the transferrin saturation index increased significantly (P = 0.04). Serum albumin and normalized protein catabolic rate, when normalized by serum P, increased, averaging 37% and 39%, respectively (P < 0.001). Adherent patients increased from 28.2% to 52.7%. Adverse effects were reported by 14.1% of participants, with abandonment of treatment in 9.5%. Conclusions The use of SO in real-life results in better control of serum P, a reduction in the number of tablets and an improvement in therapeutic adherence. In addition, it may be beneficial with regards to secondary hyperparathyroidism and nutritional status.

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