The Impact of Tenapanor on Serum Phosphate in Adult Dialysis Patients: A Narrative Review

Managing hyperphosphatemia remains a challenging feat in the dialysis population. In 2023, tenapanor, a sodium hydrogen exchanger inhibitor, was approved in the United States for treating hyperphosphatemia in adults with chronic kidney disease receiving dialysis. This narrative review evaluated the recent literature on tenapanor, its effects on serum phosphate, and the achievement of target serum phosphate reference ranges in individuals undergoing peritoneal and hemodialysis. In addition to efficacy, this review examined the prevalence of drug-induced diarrhea. Twelve articles met the inclusion criteria. Results indicate clinical and statistical differences in the mean change in serum phosphate and a greater tendency to achieve serum phosphate target reference ranges among individuals receiving dialysis who take tenapanor compared with those who do not. These findings support using tenapanor independently or in conjunction with phosphate binders to treat hyperphosphatemia. However, drug-induced diarrhea may lead to discontinuation of tenapanor therapy. Future research should focus on nutrition counseling to mitigate drug-induced diarrhea and extend tenapanor tolerance in individuals receiving dialysis.