Efficacy and Safety of Sucroferric Oxyhydroxide compared with sevelamer in Chronic Kidney Disease Patients with Hyperphosphataemia- A Pilot Study

Our study aimed to evaluate the efficacy and safety of Sucroferric oxyhydroxide (SFOH), an iron-based phosphate binder, compared to sevelamer, a non-calcium-based phosphate binder, in patients with CKD and hyperphosphatemia. Patients undergoing hemodialysis were selected based on their phosphate levels and other relevant parameters. A total of 64 patients were included and divided into two groups: sevelamer (n=32) and SFOH (n=32). Serum samples were collected at baseline and after 12 weeks. Medication adherence was assessed using the MARS-5 score. 64 patients were enrolled however only 60 patients completed the study (30 and 30 to SFOH and sevelamer respectively). In the SFOH group, the mean serum phosphate (sP) levels significantly decreased from baseline, while phosphate levels in the sevelamer group showed only a slight reduction i.e. 7.5±0.6 to 6.1±0.6 mg/dl and 7.6±0.6 to 6.5±0.5 mg/dl respectively. The reduction in serum phosphate was significantly greater in the SFOH group compared to the sevelamer group. This study demonstrates that SFOH effectively reduces serum phosphate levels, increases hemoglobin, and improves medication adherence compared to sevelamer. These findings support the use of SFOH as a beneficial phosphate binder in ESRD patients with hyperphosphatemia. SFOH medication adherence was 93.75% whereas sevelamer exhibited its adherence at 68.75% as per MARS-5 score.