Phosphate binder pill burden and cardiovascular events in patients undergoing hemodialysis.

BACKGROUND

Phosphate binders (PBs) are commonly prescribed to reduce serum phosphate levels. This study examined the association between the PB pill burden and cardiovascular events in hemodialysis patients.

METHODS

This retrospective cohort study included 395 patients undergoing hemodialysis between August 2018 and November 2023 at a single facility in Japan. Statistical analyses were conducted using baseline, time-averaged, and time-dependent Cox proportional hazard models.

RESULTS

Of the 395 included patients, cardiovascular events occurred in 121 patients (30.6%). The patients were categorized into tertiles based on their daily PB pill intake: T1 (<4 pills/day), T2 (4-8 pills/day), and T3 (≥9 pills/day). T3 was associated with increased cardiovascular risk (vs. T1 hazard ratio [HR] = 1.51, p = 0.064; vs. T2 HR = 2.06, p = 0.005). Similar results were obtained for the time-averaged and time-dependent models.

CONCLUSION

A high PB pill burden (≥9/day) is associated with increased cardiovascular risk in patients undergoing hemodialysis.