Real-World Efficacy and Safety of Tenapanor Plus Phosphate Binders in Hemodialysis Patients With Hyperphosphatemia

Inclusion Criteria: 1. The subject has provided written informed consent prior to the initiation of any study-related activities. 2. Male or female subjects aged ≥18 years at the time of signing the informed consent form. 3. The subject is receiving regular maintenance hemodialysis (3 times per week, 4 hours per session) for at least 3 months. 4. The patient has been on phosphate binder therapy for at least 3 weeks, with a stable dose. 5. Serum phosphorus \> 4.5 mg/dL. Exclusion Criteria: 1. Hypersensitivity to Tenapanor or any excipients of the formulation. 2. History of diarrhea within 1 week prior to the start of treatment. Diarrhea is defined as a Bristol Stool Form Scale (BSFS) score ≥6 (i.e., mushy or liquid stools with no solid pieces), a daily bowel movement frequency ≥3 times, and a duration of ≥2 days. 3. Life expectancy \< 6 months. 4. Expected or planned kidney transplantation during the study period. 5. History of inflammatory bowel disease (IBD) or irritable bowel syndrome with diarrhea (IBS-D). 6. Any other condition that, in the opinion of the Investigator, makes the patient unsuitable for enrollment.