Literature DB >> 20119931

Challenge of phosphorus control in hemodialysis patients: a problem of adherence?

María Dolores Arenas1, Tamara Malek, María Teresa Gil, Analía Moledous, Fernando Alvarez-Ude, Abilio Reig-Ferrer.   

Abstract

OBJECTIVE: Few studies have investigated nonadherence to phosphate binders. The aim of this study was to evaluate the degree of adherence of our hemodialysis (HD) patients to phosphate binders and to determine which variables were related to nonadherence to treatment.
METHODS: In 165 HD patients, the degree of adherence to the drugs prescribed was studied using the Simplified Medication Adherence Questionnaire.
RESULTS: Of patients, 40% were nonadherent. Specific nonadherence to phosphate binder and hypotensive medication was admitted by 21% and 13% of patients, respectively. Nonadherent patients had significantly higher mean serum phosphorus (P) (4.7 ± 0.9 mg/dL vs. 4.4 ± 0.7 mg/dL; p=0.007) and potassium levels (6.3 ± 4.4 mEq/L vs. 5.3 ± 1.4 mEq/L; p=0.04). There was a statistically significant association between mean P levels >5.5 mg/dL in the last 6 months and nonadherence to treatment (X2=4.8; 95% confidence interval [95% CI], 1.0-6.6; p=0.02). No relationship was found between patients with blood pressure levels >140/90 mm Hg and nonadherence to hypotensive medication (X2=0.02; 95% CI, 0.2-4.1; p=0.88). Patients specifically nonadherent to phosphate binders were more likely to have P levels >5.5 mg/dL (X2=4.7; 95% CI, 1.07-6.5; p=0.03). No statistically significant association was found between patients noncompliant with hypotensive agents and those noncompliant with phosphate binders (X2=0.39; 95% CI, 0.4-4.7; p=0.53). There were no significant differences between adherent and nonadherent patients in terms of age, time on hemodialysis, Charlson Comorbidity Index, number of drugs prescribed and number of tablets per day (p>0.05).
CONCLUSION: Nonadherence to pharmacological treatment in dialysis patients is high. Nonadherence to phosphate binders was greater than for hypotensive agents, did not coexist in the same patients and had a greater impact on target achievement.

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Year:  2010        PMID: 20119931

Source DB:  PubMed          Journal:  J Nephrol        ISSN: 1121-8428            Impact factor:   3.902


  32 in total

1.  Adherence to phosphate binders in hemodialysis patients: prevalence and determinants.

Authors:  Yoleen P M Van Camp; Bernard Vrijens; Ivo Abraham; Bart Van Rompaey; Monique M Elseviers
Journal:  J Nephrol       Date:  2014-02-22       Impact factor: 3.902

2.  Phosphate binder use and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS): evaluation of possible confounding by nutritional status.

Authors:  Antonio Alberto Lopes; Lin Tong; Jyothi Thumma; Yun Li; Douglas S Fuller; Hal Morgenstern; Jürgen Bommer; Peter G Kerr; Francesca Tentori; Takashi Akiba; Brenda W Gillespie; Bruce M Robinson; Friedrich K Port; Ronald L Pisoni
Journal:  Am J Kidney Dis       Date:  2012-03-03       Impact factor: 8.860

3.  Management of mineral metabolism in haemodialysis patients: need for new strategies.

Authors:  P Esposito; A Di Benedetto; T Rampino; S Stuard; D Marcelli; B Canaud; A Dal Canton
Journal:  Eur J Clin Nutr       Date:  2014-04-30       Impact factor: 4.016

Review 4.  A systematic review on the efficacy and safety of PA21 versus sevelamer in dialysis patients.

Authors:  Dengpiao Xie; Naijing Ye; Mingquan Li
Journal:  Int Urol Nephrol       Date:  2018-01-02       Impact factor: 2.370

Review 5.  Hyperphosphataemia: treatment options.

Authors:  Fabio Malberti
Journal:  Drugs       Date:  2013-05       Impact factor: 9.546

6.  Multidisciplinary education approach to optimize phosphate control among hemodialysis patients.

Authors:  Meei Wah Chan; Huey Miin Cheah; Madihah Binti Mohd Padzil
Journal:  Int J Clin Pharm       Date:  2019-07-13

Review 7.  Pharmacology, efficacy and safety of oral phosphate binders.

Authors:  Alastair J Hutchison; Craig P Smith; Paul E C Brenchley
Journal:  Nat Rev Nephrol       Date:  2011-09-06       Impact factor: 28.314

8.  Impact of community pharmacist-led intensive education on the control of serum phosphate levels in haemodialysis patients.

Authors:  Hiroshi Suzuki; Shinya Uchida; Yasuharu Kashiwagura; Shimako Tanaka; Katsuya Yamauchi; Shinji Kageyama; Noriyuki Namiki
Journal:  Int J Clin Pharm       Date:  2020-09-21

9.  Management of mineral metabolism in hemodialysis patients: discrepancy between interventions and perceived causes of failure.

Authors:  Pasquale Esposito; Teresa Rampino; Marilena Gregorini; Carmine Tinelli; Annalisa De Silvestri; Fabio Malberti; Rosanna Coppo; Antonio Dal Canton
Journal:  J Nephrol       Date:  2014-05-08       Impact factor: 3.902

Review 10.  Phosphate binders in chronic kidney disease: a systematic review of recent data.

Authors:  Jürgen Floege
Journal:  J Nephrol       Date:  2016-01-22       Impact factor: 3.902

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