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Cinacalcet increases calcium excretion in hypercalcemic hyperparathyroidism after kidney transplantation.
Transplantation. 2008 Oct 15; 86(7):919-24.T

Abstract

BACKGROUND

Cinacalcet reduces serum calcium in kidney transplant recipients with hypercalcemic hyperparathyroidism. The mechanism of action is not fully understood. We hypothesized that cinacalcet increases renal elimination of calcium, thereby improving hypercalcemia in kidney transplant recipients.

METHODS

We prospectively examined the effect of cinacalcet (30 mg/d) during the first 6 weeks of treatment on serum and 24 hrs urinary calcium concentration and calculated fractional calcium excretion in 32 patients with sustained hypercalcemic hyperparathyroidism (Ca >2.6 mmol/L [10.4 mg/dL], intact parathyroid hormone >60 pg/mL). Secondary endpoints were serum phosphate and tubular maximum of phosphate corrected for glomerular filtration rate, intact parathyroid hormone and serum creatinine.

RESULTS

Serum calcium concentrations decreased in all patients (from 2.77 to 2.51 mmol/L; P<0.0001), fractional calcium excretion increased rapidly in the first 2 weeks of treatment from 1.06 to 1.78% (P<0.0001), and decreased thereafter to 1.37% (P<0.05 vs. early treatment). Simultaneously serum phosphate and tubular maximum of phosphate corrected for glomerular filtration rate increased significantly from 0.79 to 0.85 to 0.88 mmol/L (P<0.05), and from 0.52 to 0.61 (P<0.005) and 0.62 (P<0.0001 vs. baseline), respectively. Intact parathyroid hormone did not decrease significantly. Serum creatinine remained stable.

CONCLUSION

We provide evidence that the calcium lowering effect of cinacalcet in patients with persistent hyperparathyroidism after kidney transplantation is caused, at least in part, by increased urinary calcium excretion.

Authors+Show Affiliations

Department of Medicine III, Division of Nephrology and Dialysis, Medical University Vienna, Vienna, Austria. kyra.borchhardt@meduniwien.ac.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18852656

Citation

Borchhardt, Kyra A., et al. "Cinacalcet Increases Calcium Excretion in Hypercalcemic Hyperparathyroidism After Kidney Transplantation." Transplantation, vol. 86, no. 7, 2008, pp. 919-24.
Borchhardt KA, Heinzl H, Mayerwöger E, et al. Cinacalcet increases calcium excretion in hypercalcemic hyperparathyroidism after kidney transplantation. Transplantation. 2008;86(7):919-24.
Borchhardt, K. A., Heinzl, H., Mayerwöger, E., Hörl, W. H., Haas, M., & Sunder-Plassmann, G. (2008). Cinacalcet increases calcium excretion in hypercalcemic hyperparathyroidism after kidney transplantation. Transplantation, 86(7), 919-24. https://doi.org/10.1097/TP.0b013e318186b7fb
Borchhardt KA, et al. Cinacalcet Increases Calcium Excretion in Hypercalcemic Hyperparathyroidism After Kidney Transplantation. Transplantation. 2008 Oct 15;86(7):919-24. PubMed PMID: 18852656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cinacalcet increases calcium excretion in hypercalcemic hyperparathyroidism after kidney transplantation. AU - Borchhardt,Kyra A, AU - Heinzl,Harald, AU - Mayerwöger,Elisabeth, AU - Hörl,Walter H, AU - Haas,Martin, AU - Sunder-Plassmann,Gere, PY - 2008/10/15/pubmed PY - 2008/11/18/medline PY - 2008/10/15/entrez SP - 919 EP - 24 JF - Transplantation JO - Transplantation VL - 86 IS - 7 N2 - BACKGROUND: Cinacalcet reduces serum calcium in kidney transplant recipients with hypercalcemic hyperparathyroidism. The mechanism of action is not fully understood. We hypothesized that cinacalcet increases renal elimination of calcium, thereby improving hypercalcemia in kidney transplant recipients. METHODS: We prospectively examined the effect of cinacalcet (30 mg/d) during the first 6 weeks of treatment on serum and 24 hrs urinary calcium concentration and calculated fractional calcium excretion in 32 patients with sustained hypercalcemic hyperparathyroidism (Ca >2.6 mmol/L [10.4 mg/dL], intact parathyroid hormone >60 pg/mL). Secondary endpoints were serum phosphate and tubular maximum of phosphate corrected for glomerular filtration rate, intact parathyroid hormone and serum creatinine. RESULTS: Serum calcium concentrations decreased in all patients (from 2.77 to 2.51 mmol/L; P<0.0001), fractional calcium excretion increased rapidly in the first 2 weeks of treatment from 1.06 to 1.78% (P<0.0001), and decreased thereafter to 1.37% (P<0.05 vs. early treatment). Simultaneously serum phosphate and tubular maximum of phosphate corrected for glomerular filtration rate increased significantly from 0.79 to 0.85 to 0.88 mmol/L (P<0.05), and from 0.52 to 0.61 (P<0.005) and 0.62 (P<0.0001 vs. baseline), respectively. Intact parathyroid hormone did not decrease significantly. Serum creatinine remained stable. CONCLUSION: We provide evidence that the calcium lowering effect of cinacalcet in patients with persistent hyperparathyroidism after kidney transplantation is caused, at least in part, by increased urinary calcium excretion. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/18852656/Cinacalcet_increases_calcium_excretion_in_hypercalcemic_hyperparathyroidism_after_kidney_transplantation_ L2 - https://doi.org/10.1097/TP.0b013e318186b7fb DB - PRIME DP - Unbound Medicine ER -