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Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients.
Nephrol Dial Transplant. 2007 Feb; 22(2):577-83.ND

Abstract

BACKGROUND

Cinacalcet rapidly normalizes serum calcium and reduces intact parathyroid hormone (PTH) levels in renal transplant patients with hypercalcaemia and persistent hyperparathyroidism. The aim of this study is to evaluate the 6 months efficacy of cinacalcet and the effect of cinacalcet withdrawal on serum calcium and PTH in such patients. Furthermore, the impact of cinacalcet on bone turnover and quality of life was assessed.

METHODS

Twelve renal allograft recipients with hypercalcaemia due to persistent hyperparathyroidism were treated with cinacalcet for 26 weeks. Cinacalcet was then withdrawn to check for recurrence of hypercalcaemia.

RESULTS

Cinacalcet maintained normocalcaemia in all patients from week 4 to 26, and PTH significantly decreased and remained suppressed. Serum phosphate increased, whereas the serum calcium-phosphate product remained unchanged. The excretion of calcium and phosphate in the 24 h urine had tendency to decrease. After cinacalcet was withdrawn, hypercalcaemia recurred rapidly and PTH increased to baseline values. Renal function remained stable, proteinuria was unchanged and no allograft rejection was observed. During treatment with cinacalcet, total and bone-specific alkaline phosphatase increased, whereas the urinary deoxypyridinoline-creatinine ratio did not change significantly, suggesting enhanced bone formation. Quality of life assessed at weeks 10 and 26 remained unchanged compared with baseline.

CONCLUSIONS

In conclusion, continued treatment with cinacalcet is required to maintain long-term normocalcaemia and to suppress the enhanced PTH production in renal transplant recipients with persistent hyperparathyroidism.

Authors+Show Affiliations

Clinic for Nephrology, University Hospital, Rämistrasse 100, 8091 Zürich, Switzerland. andreas.serra@usz.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17005527

Citation

Serra, Andreas L., et al. "Effective Control of Persistent Hyperparathyroidism With Cinacalcet in Renal Allograft Recipients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 22, no. 2, 2007, pp. 577-83.
Serra AL, Savoca R, Huber AR, et al. Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients. Nephrol Dial Transplant. 2007;22(2):577-83.
Serra, A. L., Savoca, R., Huber, A. R., Hepp, U., Delsignore, A., Hersberger, M., & Wüthrich, R. P. (2007). Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 22(2), 577-83.
Serra AL, et al. Effective Control of Persistent Hyperparathyroidism With Cinacalcet in Renal Allograft Recipients. Nephrol Dial Transplant. 2007;22(2):577-83. PubMed PMID: 17005527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients. AU - Serra,Andreas L, AU - Savoca,Reto, AU - Huber,Andreas R, AU - Hepp,Urs, AU - Delsignore,Aba, AU - Hersberger,Martin, AU - Wüthrich,Rudolf P, Y1 - 2006/09/27/ PY - 2006/9/29/pubmed PY - 2007/7/10/medline PY - 2006/9/29/entrez SP - 577 EP - 83 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 22 IS - 2 N2 - BACKGROUND: Cinacalcet rapidly normalizes serum calcium and reduces intact parathyroid hormone (PTH) levels in renal transplant patients with hypercalcaemia and persistent hyperparathyroidism. The aim of this study is to evaluate the 6 months efficacy of cinacalcet and the effect of cinacalcet withdrawal on serum calcium and PTH in such patients. Furthermore, the impact of cinacalcet on bone turnover and quality of life was assessed. METHODS: Twelve renal allograft recipients with hypercalcaemia due to persistent hyperparathyroidism were treated with cinacalcet for 26 weeks. Cinacalcet was then withdrawn to check for recurrence of hypercalcaemia. RESULTS: Cinacalcet maintained normocalcaemia in all patients from week 4 to 26, and PTH significantly decreased and remained suppressed. Serum phosphate increased, whereas the serum calcium-phosphate product remained unchanged. The excretion of calcium and phosphate in the 24 h urine had tendency to decrease. After cinacalcet was withdrawn, hypercalcaemia recurred rapidly and PTH increased to baseline values. Renal function remained stable, proteinuria was unchanged and no allograft rejection was observed. During treatment with cinacalcet, total and bone-specific alkaline phosphatase increased, whereas the urinary deoxypyridinoline-creatinine ratio did not change significantly, suggesting enhanced bone formation. Quality of life assessed at weeks 10 and 26 remained unchanged compared with baseline. CONCLUSIONS: In conclusion, continued treatment with cinacalcet is required to maintain long-term normocalcaemia and to suppress the enhanced PTH production in renal transplant recipients with persistent hyperparathyroidism. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/17005527/Effective_control_of_persistent_hyperparathyroidism_with_cinacalcet_in_renal_allograft_recipients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfl560 DB - PRIME DP - Unbound Medicine ER -