Prescribed Meds May Up Phosphate Burden in Hemodialysis Patients
Study implicates amlodipine, lisinopril, clonidine, acetaminophen, and omeprazole.
CHICAGO—Medications commonly prescribed for in-center hemodialysis (HD) patients may add to their overall daily phosphate load, investigators concluded in a poster presentation at the American Society of Nephrology's 2016 Kidney Week meeting.
Dixie-Ann Sawin, PhD, and colleagues at Fresenius Medical Care North America (FMCNA), based in Waltham, Massachusetts, reviewed 695,759 prescriptions for FMCNA in-center HD patients and found that the top 5 prescribed drug classes were calcium-channel blockers (22%), proton pump inhibitors (PPIs, 18%), acetaminophen-opioid (13%), ACE inhibitors (10%), and alpha-2 agonists (9%). The top 5 medication orders were amlodipine, lisinopril, clonidine, acetaminophen-opioid, and omeprazole. On average, the addition phosphate added to patients' daily intake was 36.2 mg for amlodipine, 75–148.8 mg for lisinopril, 2.9–7.2 mg for clonidine, 0 mg for acetaminophen-opioid, and 204.8–234 mg for omeprazole per day.
The investigators concluded that increased phosphate content in medications prescribed to in-center HD patients may contribute to their overall daily phosphate load, requiring more phosphate binders and thus increasing daily pill burden and affecting medication adherence.
- Sawin DA et al. Increased phosphate burden from medications prescribed to in-center hemodialysis patients. Poster presented at the 2016 Kidney Week meeting in Chicago, Nov. 15-20.