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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Polypharmacy is a well-known issue affecting the majority of patients undergoing dialysis. Among the various medications prescribed, phosphate binders are the major cause of dose burden in patients receiving dialysis. Recently, tenapanor was approved as a novel drug that controls serum phosphate levels by inhibiting the intestinal sodium-hydrogen exchanger 3 (NHE3). Clinical trials have demonstrated that tenapanor can reduce the dose burden of phosphate binders, leading to an increase in diarrhea. Conversely, tenapanor could reduce the dose burden of laxatives, potassium-binding agents, and antihypertensive medications. However, the potential effect of tenapanor on polypharmacy remains insufficiently explored by real-world data.
A retrospective cohort study was conducted using data from patients undergoing dialysis at two hospitals in Japan to evaluate changes in the prescription doses of phosphate binders, laxatives, potassium-binding agents, and antihypertensive medications after the initiation of tenapanor over 24 weeks. To ensure comparability, the control group was selected between 2017 and 2025 to balance the dialysis vintage with that of the tenapanor group. A negative-binomial generalized linear mixed-effect model adjusted by potential confounders was applied to assess the longitudinal change in doses between two groups.
Among 143 patients with available data, 43 received tenapanor. At baseline, the tenapanor group was characterized by younger age (60.8±12.5 vs 66.1±11.3 years) and longer dialysis vintage (7.7±12.5 vs 6.9±7.1 years) compared to the control group. Additionally, the tenapanor group exhibited a higher median phosphate binder dose (9 vs 5 doses) and a higher dialysis prescription of Kt/V (1.71 vs 1.46). The analysis using a negative binomial regression model revealed a significant decrease in the total prescribed dose of phosphate binders in the tenapanor group (p < 0.001, Wald test for slope), with an estimated dose reduction rate of 26% (95% confidence interval: 11 to 40 %) from week 0 to week 24. This reduction was not observed in the control group (26% reduction; 95% confidence interval: -11% to 68%). Moreover, the significant decrease in the phosphate-binder dose persisted among the tenapanor group (31% reduction; 95% confidence interval: 3% to 51%) after adjusting for baseline covariates, including age, sex, dialysis vintage, serum phosphate level, dialysis modality, and baseline phosphate levels. Yet, no statistically significant differences were found at baseline or in the slopes of prescription doses for laxatives, potassium-binding agents, and antihypertensive medications.
This study demonstrated that tenapanor use was associated with a significant decrease in the prescription dose of phosphate binders after controlling for the potential confounders. However, no secondary effects of tenapanor were observed in the prescription dose of laxatives, potassium-binding agents, and antihypertensive drugs. Although there are several limitations, such as potential poor adherence and a relatively small sample size, these findings suggest that tenaparnor could be a potential key drug to reducing the overall dose burden related to polypharmacy in patients receiving dialysis.
