Evidence map›Paper›PMID 40526762›Full record

Trial reportPloS one2025

Efficacy of tenapanor in managing hyperphosphatemia and constipation in hemodialysis patients: A randomized controlled trial.

Naoki Suzuki, Yuuki Takeda, Akie Kabuto, Takao Konishi, Takahiro Konishi, Fumi Sumino, Hayanari Iwata, Mone Iwagami, Yusuke Kouchi, Yasumasa Hitomi and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Tenapanor Beyond Phosphate: Gut Sodium Transport, Stool Transit Time, and Volume Balance in Dialysis Patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2026
    Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Naoki SuzukiDivision of Data science, Tojinkai Hospital, Kyoto, Japan.ORCID 0000-0002-9748-6777
Yuuki TakedaDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Akie KabutoDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Takao KonishiDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Takahiro KonishiDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Fumi SuminoDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Hayanari IwataDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Mone IwagamiDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Yusuke KouchiDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.
Yasumasa HitomiDivision of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan.ORCID 0000-0003-3850-248X
Toru TakataniNephrology Division, Tojinkai Satellite Clinic, Kyoto, Japan.
Masato NishimuraCardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan.
Nodoka SatoUrology Division, Tojinkai Hospital, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTenapanor is a minimally absorbed, small-molecule inhibitor of sodium/hydrogen exchanger 3 and thus suppresses sodium absorption in the gastrointestinal tract. It is approved by the FDA for the treatment of hyperphosphatemia in dialysis patients. This randomized controlled trial evaluated its efficacy in the treatment of hyperphosphatemia and constipation in hemodialysis patients.

methodsNinety hemodialysis patients were randomized 1:1 to receive either tenapanor or standard care. Randomization was performed using a computer-generated sequence stratified by baseline serum phosphorus levels. The tenapanor group began treatment with a dosage of 10 mg/day, which was adjusted based on serum phosphorus levels. Primary outcomes were changes in serum phosphorus levels in the tenapanor and control groups and changes in stool consistency, assessed weekly using the Bristol Stool Form Scale (BSFS) in the tenapanor group. Secondary outcomes included laxative use and phosphate binder prescription patterns. Serum phosphorus levels, serum calcium, albumin, and related biochemical parameters were monitored every two weeks. Data were analyzed using intention-to-treat principles. This study was not blinded.

resultsOf the 90 randomized participants, 69 completed the 23-week study. Tenapanor significantly improved stool consistency and resolved constipation (BSFS types 1-2) by week 5. A transient increase in loose stools (BSFS types 6-7) occurred early, with 10 participants discontinuing due to diarrhea. Laxative use decreased significantly in the tenapanor group, from 58.2% at baseline to 35.6% at week 23 (p < 0.01). Serum phosphorus levels were decreased in both groups, with comparable control. Lanthanum carbonate prescriptions decreased significantly in the tenapanor group and were largely replaced by low-dose tenapanor.

conclusionTenapanor improves stool consistency, reduces laxative use, and provides effective phosphorus control in hemodialysis patients and represents a promising alternative to conventional phosphate binders.

Indexed as

ConstipationHyperphosphatemiaRenal DialysisAdultAgedFemaleHumansIsoquinolinesLaxativesMaleMiddle AgedPhosphorusSulfonamidesTreatment OutcomeIsoquinolinesLaxativesPhosphorusSulfonamidestenapanor

Identifiers

PMID40526762
PMCPMC12173349

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.