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Resumen: Introducción: Las alteraciones del metabolismo óseo y mineral son muy frecuentes en la enfermedad renal crónica (ERC). El aumento en los niveles de fósforo condiciona enfermedad ósea, riego de calcificación y mayor mortalidad, por lo que cualquier estrategia encaminada a su reducción debe ser bienvenida. El último fármaco incorporado al arsenal terapéutico para tratar la hiperfosforemia en la ERC es el oxihidróxido sucroférrico (OSF). Objetivo: Analizar la eficacia y seguridad de OSF en 3 cohortes de pacientes, una con ERC avanzada no en diálisis, otra en diálisis peritoneal y finalmente otra en hemodiálisis, seguidas durante 6 meses. Métodos: Estudio observacional multicéntrico, prospectivo, de práctica clínica. Se analizaron variables clínicas y epidemiológicas. Se valoró la evolución de parámetros relacionados con las alteraciones del metabolismo óseo y mineral y la anemia. Resultados: Se incluyeron en el estudio 85 pacientes (62 ± 12 años, 64% varones, 34% diabéticos), 25 con ERC avanzada no en diálisis, 25 en diálisis peritoneal y finalmente 35 en hemodiálisis. En 66 pacientes (78%) OSF fue el primer captor del fósforo; en los otros 19 se sustituyó un captor previo por OSF, por falta de tolerancia o eficacia. La dosis inicial de OSF fue 964 ± 323 mg/día. Globalmente los niveles séricos de fósforo experimentaron un descenso significativo a los 3 meses de tratamiento (19,6%; p

Alterations in bone and mineral metabolism are very common in chronic kidney disease (CKD). The increase in phosphate levels leads to bone disease, risk of calcification and greater mortality, so any strategy aimed at reducing them should be welcomed. The latest drug incorporated into the therapeutic arsenal to treat hyperphosphataemia in CKD is sucroferric oxyhydroxide (SFO).To analyse the efficacy and safety of SFO in 3 cohorts of patients, one with advanced CKD not on dialysis, another on peritoneal dialysis and the last on haemodialysis, followed for 6 months.A prospective, observational, multicentre study in clinical practice. Clinical and epidemiological variables were analysed. The evolution of parameters relating to alterations in bone and mineral metabolism and anaemia was analysed.Eighty-five patients were included in the study (62±12 years, 64% male, 34% diabetic), 25 with advanced CKD not on dialysis, 25 on peritoneal dialysis and lastly, 35 on haemodialysis. In 66 patients (78%), SFO was the first phosphate binder; in the other 19, SFO replaced a previous phosphate binder due to poor tolerance or efficacy. The initial dose of SFO was 964±323mg/day. Overall, serum phosphate levels saw a significant reduction at 3 months of treatment (19.6%; P.001). There were no differences in the efficacy of the drug when the different populations analysed were compared. Over the course of the study, there were no changes to levels of calcium, PTHi, ferritin, transferrin saturation index or haemoglobin, although there was a tendency for the last 2 to increase. Twelve patients (14%) withdrew from follow-up, 10 due to gastrointestinal adverse effects (primarily diarrhoea) and 2 were lost to follow-up (kidney transplant). The mean dose of the drug that the patients received increased over time, up to 1,147±371mg/day.SFO is an effective option for the treatment of hyperphosphataemia in patients with CKD both in the advanced phases of the disease and on dialysis. We found similar efficacy across the 3 groups analysed. The higher their baseline phosphate level, the greater the reduction in the serum levels. A notable reduction in phosphate levels can be achieved with doses of around 1,000mg/day. Diarrhoea was the most common side effect, although it generally was not significant.