Niacinamide may be effective in reducing serum phosphate in patients on hemodialysis
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Key takeaways:
- Niacinamide was well-tolerated and did not increase the risk of thrombocytopenia.
- The treatment significantly reduced serum phosphate with a 0.59 mg/dL dosage.
Niacinamide may be an effective method to reduce serum phosphate concentrations in patients with kidney failure on hemodialysis, according to results of a published crossover trial.
“Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders,” Lara Schepers, MSc, of the division of human nutrition and health at Wageningen University and Research in the Netherlands, wrote with along with colleagues. “Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as ‘add-on’ treatment to reduce serum phosphate concentrations in this population. NAM seems to lack many of the side effects that are observed with niacin.”
Researchers conducted a double-blind, placebo-controlled study to compare use of 250 mg to 500 mg per day of niacinamide to placebo for 12 weeks in patients already on approved phosphate binders. Overall, 35 patients in a dialysis ward were randomly selected between 2015 and 2016 to participate in the study. Primary outcome was reduction in serum phosphate concentrations, with secondary outcomes including platelet counts and adverse event-related dropouts.
Niacinamide was well-tolerated and did not increase the risk of thrombocytopenia, according to the findings.
The treatment significantly reduced serum phosphate with a 0.59 mg/dL niacinamide dosage. Linear mixed models showed superiority of 12 weeks of niacinamide vs. 12 weeks of placebo with a between-treatment difference of 0.77 mg/dL. Although there were no significant differences in platelet counts between the treatment groups, according to the results, three patients did experience adverse events leading to dropouts during the NAM treatment period.
“NAM is effective in reducing serum phosphate concentrations in patients with kidney failure receiving hemodialysis,” Schepers and colleagues wrote. “In addition, NAM is well-tolerated and seems not to increase the risk of thrombocytopenia. However, more research in larger populations is needed to confirm this.”
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