New hope for kidney dialysis patients

New hope for kidney dialysis patients

Rachael Clegg
Manchester Evening News - UK
9/ 5/2007

PATIENTS on kidney dialysis can need up to 12 doses of medication a day to regulate their phosphate levels. Now the introduction of new drug, Fosrenol, means their pill burden can be cut by more than 75 per cent. Rachael Clegg reports.

Retired GP Simon Jenkins, like many kidney patients on dialysis, suffered from raised phosphate levels, known as hyperphosphataemia, as a result of his condition.

He is one of more than 23,000 people in the UK diagnosed with end stage renal disease, about 70 per cent of whom have hyperphosphataemia – a condition which until recently has meant taking up to 12 phosphate-binding tablets a day to control.

The high dose medication meant that many patients frequently missed doses. So, when clinical trials became available to test a new medication which required only two or three tablets a day, Simon was keen to take part.

Discomfort

“Because of my high phosphate levels I had constant itchy skin that was so bad that it would keep me awake at night,” explains the 69-year-old from Whitefield.

“Nothing seemed to relieve it. Even getting up and having a cold shower gave little relief. I was increasingly anxious because I knew what could happen if my phosphate levels got too high."

Phosphate is a mineral which we absorb from our food. However, patients with kidney disease are unable to remove waste and toxins effectively from their body. Dialysis can remove much of the waste from the blood, but is unable to filter out phosphate for the majority of patients. Symptoms of abnormally high phosphate levels include tiredness, restless legs, reduced sex drive and incessant itching of the skin.

Out of control

If not managed successfully, hyperphosphataemia can cause serious long-term health risks leading to renal osteodystrophy (resulting in bone pain, brittle bones and skeletal deformities) and potentially contributing to cardiovascular disease, which accounts for almost half of all deaths among dialysis patients.

“I was delighted when they chose me to do the extended trial of Fosrenol,” says Simon, who took part in a double blind clinical trial of Fosrenol in which, to eliminate bias, neither the patients nor doctors knew who had the placebo drug and who had the active drug.

“I knew immediately I had the active drug because the itching stopped and I no longer had these distressing symptoms – I also knew my phosphate levels had gone down which had not happened with the other phosphate binding drugs I had previously been prescribed.

“It was great that the Fosrenol didn't taste of anything as the phosphate drugs I was previously taking were chalky and unpleasantly sweet. Also, it was a huge advantage having to take far fewer tablets – two or three instead of 12-15 tablets a day.”

Since taking part in the trial, Simon has undergone a successful kidney transplant and now no longer needs to take Fosrenol. However, in his position as vice chairman of the Kidney Patient's Association he would recommend it to anyone in a similar situation.

“It was a great drug for me,” he adds. “I was on it with no side effects until I was lucky enough to have a donated kidney transplant and it made a hell of a difference to my life.”

More information

Fosrenol is an effective non-calcium phosphate binder, which maintains control of phosphate levels and is well-tolerated by the majority of patients. It provides a new option for the control of hyperphosphataemia in chronic renal failure patients on haemodialysis or continuous ambulatory peritoneal dialysis. Most patients can be managed with one chewable tablet during each meal.

Dr Alastair Hutchison, from the Manchester Institute of Nephrology & Transplantation, co-ordinated the Fosrenol trial in Europe and welcomes its launch in the UK.

“Control of hyperphosphataemia remains an unmet clinical need in many patients with chronic kidney disease, with many still having phosphate levels well above the recommended limit. The introduction of Fosrenol to the UK provides patients with a new, effective therapy that is easy and convenient to take, helping to simplify their control of phosphate levels.

"If you're being asked to take 12 – 15 tablets a day the chances are you'll forget at times. Itching of the skin is something that dialysis patients get all the time but it's the long term effects of elevated phosphate levels that are more troublesome such as hardening of the arteries which occurs over months to years and yet patients can be unaware that it is happening."

“We hope that reducing patient's phosphate level to more normal values by using Fosrenol in association with good dialysis will help prevent this.”

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