Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Oct 10, 2018; 7(6): 123-128
Published online Oct 10, 2018. doi: 10.5527/wjn.v7.i6.123
Bicarbonate levels in hemodialysis patients switching from lanthanum carbonate to sucroferric oxyhydroxide
Aristeidis Stavroulopoulos, Vasiliki Aresti, Christoforos Papadopoulos, Panagiotis Nennes, Polixeni Metaxaki, Anastasios Galinas
Aristeidis Stavroulopoulos, Vasiliki Aresti, Christoforos Papadopoulos, Panagiotis Nennes, Polixeni Metaxaki, Anastasios Galinas, Department of Nephrology, IASIO Hospital, General Clinic of Kallithea, Athens 17676, Greece
Author contributions: All of the authors contributed to the study design; Stavroulopoulos A, Aresti V and Papadopoulos C collected the data; Stavroulopoulos A analyzed the data and drafted the manuscript; all authors contributed to the conception of the paper, interpretation of data, and subsequent revisions of the manuscript.
Institutional review board statement: The protocol for the research project has been approved by the IASIO Hospital’s Ethics Committee and conforms to the provisions of the Declaration of Helsinki.
Informed consent statement: Informed written consent was obtained from all patients before they entered the study.
Conflict-of-interest statement: None to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Aristeidis Stavroulopoulos, BM BCh, MD, Chief Doctor, Doctor, Department of Nephrology, IASIO Hospital, General Clinic of Kallithea, Sivitanidou 36, Athens 17676, Greece. stavoulopoulos@yahoo.co.uk
Telephone: +30-69-47824197 Fax: +30-21-09583722
Received: June 4, 2018
Peer-review started: June 4, 2018
First decision: July 11, 2018
Revised: August 2, 2018
Accepted: August 30, 2018
Article in press: August 30, 2018
Published online: October 10, 2018
Abstract
AIM

To examine possible alterations in acid-base parameters in patients switching from lanthanum carbonate (LanC) to sucroferric oxyhydroxide (SFOH).

METHODS

Fifteen stable hemodialysis patients were switched from LanC to SFOH. Only nine continued on SFOH, three returned to LanC and the other three switched to sevelamer carbonate. The later six patients served as a control group to the SFOH group of nine patients. Blood was sampled on the 3-d and the last 2-d interval of the week prior to switching and six weeks after. Bicarbonate levels (HCO3-), pH, pO2, pCO2 were measured, and the mean of the two measurements (3-d and 2-d interval) was calculated.

RESULTS

Comparing pre-switching to post-switching measurements in the SFOH group, no statistically significant differences were found in any of the parameters studied. The mean pre-switching HCO3- was 22.41 ± 1.66 mmol/L and the mean post-switching was 22.62 ± 2.25 mmol/L (P = 0.889). Respectively, the mean pH= 7.38 ± 0.03 vs 7.39 ± 0.03 (P = 0.635), mean pCO2= 38.41 ± 3.29 vs 38.37 ± 3.62 mmHg (P = 0.767), and Phosphate = 1.57 ± 0.27 vs 1.36 ± 0.38mmol/L (P = 0.214). There were not any significant differences when we performed the same analyses in the control group or between the SFOH group and control group. No correlations were found, either between pre-switching LanC daily dose or between post-switching daily dose of the new binder and the measured parameters.

CONCLUSION

In our small study, switching from LanC to SFOH did not have any significant effect on blood bicarbonate levels and gas analysis, indicating that there is no need to change hemodialysis prescription regarding these parameters.

Keywords: Gas analysis, Hemodialysis, Lanthanum carbonate, Acidosis, Bicarbonate, Phosphate binder, Sucroferric oxyhydroxide

Core tip: Phosphate binders used for the control of hyperphosphatemia contribute to acid-base balance through their effect on serum phosphate and through the effect of the binders’ constituents that have alkaline or acidic properties. This is the first study showing that switching from Lanthanum Carbonate to the novel phosphate binder sucroferric oxyhydroxide did not have any significant effect on blood bicarbonate levels and gas analysis. Thus, there is no need to change hemodialysis prescription regarding these parameters.