Experience of the use of iron oxyhydroxide complex for the treatment of hyperphosphatemia in patients with stage 5 diabetic chronic kidney disease at the stage of starting dialysis therapy

Objective. To evaluate the efficacy and safety of the use of iron oxyhydroxide complex (Velphoro 500) in the treatment of hyperphosphatemia in patients with diabetic CKD 5D stage. Materials and methods. The study included 30 patients with diabetic CKD 5D stage (18 men and 12 women, average age was 58.6±11.5 years). The median duration of CKD was 13 years [3; 28], CKD 3A-5 stages - 3.8 years [1; 6.2], DM2 - 18 years [6; 32.5]. Patients underwent initiation of hemodialysis treatment with subsequent follow-up for 2 months. Initially, patients did not receive phosphate-binding drugs (PBDs); they only kept a diet aimed at reducing hyperphosphatemia. Due to inefficiency of dietary therapy, Ca-free PBD was administered - an iron oxyhydroxide complex (Velphoro®500) at the initial dose of 3 tablets/day, followed by dose adjustment after 1, 2, 4, and 8 weeks. Results. The use of the iron oxyhydroxide complex ensured the achievement of target phosphate levels of less than 1.49 mmol/L within 2 months of treatment in 29 of 30 treated patients. In the majority of patients (87%), target phosphate levels were noted after 4 weeks of therapy, in two of them - by the end of the first week. Analysis of possible adverse effects when using the iron oxyhydroxide complex showed that diarrhea was observed in 2 cases out of 30 (6.7%). Diarrhea was mild and resolved spontaneously for 1-3 days. Conclusion. Combined therapy of hyperphosphatemia with the use of iron oxyhydroxide complex in diabetic CKD stage 5D demonstrates its high efficacy and safety in the absence of manifestations of drug-drug interaction with atorvastatin and oral antidiabetic drugs.

diabetic chronic kidney disease, hyperphosphatemia, phosphate-binding drugs, iron oxyhydroxide complex, Velphoro