Phosphate-Binder Choice Could Impact Missed Dialysis Sessions

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DENVER—Use of sevelamer rather than calcium-based calcium binders (CBBs) to treat hyperphosphatemia in dialysis patients is associated with a reduction in missed in-center dialysis treatments regardless of dialysis organization size, a modeled analysis found.

Using a disease simulation model and published clinical data associating sevelamer with a reduction in hospitalization and hospital length of stay relative to CBBs, researchers quantified the number of missed in-center dialysis sessions according to the phosphate binders patients used (sevelamer or CBBs). Hypothetical patient cohorts were categorized according to the size of the dialysis organization that provided treatment (small: 75 patients; mid-size: 30,000 patients; and large: 120,000 patients). The analysis assumed a dialysis schedule of three treatments per week.

Over a one-year time horizon, the use of CBBs was associated with an increased number of missed in-center dialysis treatments compared with the use of sevelamer. “The magnitude of sevelamer's impact on maintaining in-center dialysis treatments increased with the size of the dialysis population,” the investigators noted in an abstract (PUB490).

Among small dialysis organizations, the modeled number of missed in-center treatments due to hospitalization was 446 for users of CBBs and 395 for sevelamer users. Among mid-size organizations, the numbers were 178,714 and 158,142, respectively. Among large organizations, the numbers were 714,857 and 632,571, respectively.

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