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Regional prescription surveillance of phosphate binders in the western Saitama area: the substantial role of ferric citrate hydrate in improving serum phosphorus levels and erythropoiesis

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A Correction to this article was published on 25 September 2019

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Abstract

Background

In April 2015, five types of phosphate binders (PBs) were available by prescription in Japan, namely calcium carbonate, sevelamer hydrochloride, lanthanum carbonate, bixalomer, and ferric citrate hydrate (FeC). FeC reduces serum phosphorus levels and increases the body’s iron stores. However, it is unclear whether FeC lowers serum phosphorus relative to other agents in a regional practical setting.

Methods

We performed a retrospective observational cohort study of regional hemodialysis surveillance in the western Saitama area of Japan, which included 1374 hemodialysis patients enrolled from 32 satellite dialysis units. The clinical data and prescribing information were retrospectively collected and analyzed. The difference in serum phosphorus among the groups administered five types of PBs (new or additional) from April to September 2015 was the primary outcome.

Results

As of April 2015, the median values of serum phosphorus, corrected calcium, and intact parathyroid hormone were 5.4 mg/dL, 9.1 mg/dL, and 147 pg/dL, respectively (N = 1374). Unexpectedly, with an increase in the number of PBs administered, serum phosphorous levels increased (p < 0.001). The significant changes in the serum phosphorus and hemoglobin levels were associated with the prescription of FeC but not with that of the other PBs.

Conclusions

This regional survey suggests that serum phosphorus is well managed and that FeC has the potential to reduce the serum phosphorus level relative to other PBs and to ameliorates anemia.

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Change history

  • 25 September 2019

    In the Original publication, Under the table 1, the number of participants in the April has been incorrectly published as 1373. The corrected table is given below.

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Acknowledgements

The authors acknowledge all hemodialysis facilities participated: Wakaba Internal Clinic, Ome Kidney Clinic, Musashimurayama Hospital, Koujinkai Takasaka Medical Clinic, Gyoda General Hospital, Ikebukuro Hospital, Ogose Medical Clinic, Kanetsu Hospital, Matsumoto Clinic, Kobayashi Internal Clinic, Tsurugashima Ekimae Clinic, Oka Hospital, Higashihanno Ekimae Clinic, Kamino Clinic, Kokusaiji Clinic, Yoriihoncyo Clinic, Sakura Memorial Hospital, Shalom Hospital, Gyoda Central General Hospital, Higashimatsuyama Kojin Clinic, Koujinkai Ogawa Hospital, Chichibu Municipal hospital, Okamura Memorial Hospital, Chichibu Daiichi Hospital, Musashidai Hospital, Minano Hospital.

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Authors and Affiliations

  1. Department of Nephrology, Faculty of Medicine, Saitama Medical University, 38, Morohongo, Moroyama-machi, Irumagun, Saitama, Japan

    Hiroaki Amano, Yoichi Ohno, Tsutomu Inoue, Koji Tomori & Hirokazu Okada

  2. Community Health Science Center, Saitama Medical University, 38, Morohongo, Moroyama-machi, Irumagun, Saitama, Japan

    Yoichi Ohno

  3. Hemodialysis Unit, Saitama Medical University, 38, Morohongo, Moroyama-machi, Irumagun, Saitama, Japan

    Kazuya Ohama

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  1. Hiroaki Amano
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Correspondence to Hirokazu Okada.

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Conflict of interest

The contributing authors reported the following financial supports: Hirokazu Okada received Astellas Pharma Inc, Takeda Pharmacological Company, Pfizer Japan Inc, MSD Inc, Novartis Pharma Japan, Otsuka Pharmacological Inc, Kyowa Hakko Kirin, Daiichi Sankyo Inc, Mitsubishi Tanabe Parma, Cyugai Pharma, Torii Pharma, Bayer Yakuhin, Boehringer-Ingelheim Japan, and Eli Lilly Japan.

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 16–023) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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We obtained consent through the opt-out procedure from all individual participants included in the study.

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Amano, H., Ohno, Y., Inoue, T. et al. Regional prescription surveillance of phosphate binders in the western Saitama area: the substantial role of ferric citrate hydrate in improving serum phosphorus levels and erythropoiesis. Clin Exp Nephrol 23, 841–851 (2019). https://doi.org/10.1007/s10157-019-01715-8

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