Tags

Type your tag names separated by a space and hit enter

Evolution of secondary hyperparathyroidism after kidney transplantation in patients receiving cinacalcet on dialysis.
Transplant Proc. 2009 Jul-Aug; 41(6):2396-8.TP

Abstract

BACKGROUND

Secondary hyperparathyroidism (SHPT) is a relevant problem in patients undergoing dialysis, and cinacalcet hydrochloride seems to be the best option for controlling it. After kidney transplantation (KTx), moderate to severe SHPT may persist and cause hypercalcemia and hypophosphatemia, among other deleterious effects. The number of patients receiving cinacalcet before KTx is increasing.

OBJECTIVE

To evaluate the evolution of calcemia, phosphatemia, and intact parathyroid hormone (iPTH) after KTx in patients with SHPT receiving cinacalcet on dialysis.

PATIENTS AND METHODS

The study included 19 patients (15 men and 4 women; mean [SD] age, 52 [13] years) undergoing dialysis and receiving cinacalcet before KTx. Mean duration of dialysis before KTx was 33 (25) months, and cinacalcet dose was 45 (15) mg/d. Creatinine, calcium, phosphorus, alkaline phosphatase, and iPTH concentrations were evaluated at baseline (day of surgery), at 15 days after surgery, and then monthly for 6 months. In all patients, cinacalcet therapy was discontinued on the day of surgery.

RESULTS

After the first month post-KTx, mean (SD) serum creatinine concentration was 1.6 (0.4) mg/dL and remained stable during follow-up. Calcium and phosphorus concentrations were normal in 13 patients after KTx; however, in 6 patients, hypercalcemia (calcium concentration, 11 [1.3] mg/dL) or hypophosphatemia (phosphorus concentration, 1.7 [0.6] mg/dL) developed, with iPTH concentration of 557 (400) pg/mL and alkaline phosphatase concentration of 307 (114) IU/mL. Treatment with cinacalcet resulted in correction of calcium and phosphorus concentrations (10.1 [0.4] mg/dL and 1.7 [0.7] mg/dL, respectively). Patients in whom hypercalcemia or hypophosphatemia developed were receiving cinacalcet, 60 mg/d or more, during dialysis therapy. Patients who received cinacalcet, 30 mg/d, before KTx did not exhibit hypercalcemia or hypophosphatemia after KTx.

CONCLUSION

In patients with HPT undergoing dialysis and receiving cinacalcet, 60 mg/d or more, this drug therapy should be continued after KTx to avert development of hypercalcemia or hypophosphatemia.

Authors+Show Affiliations

Nephrology and Renal Transplant Service, Hospital Clinic, Barcelona, Spain. vtorre@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19715931

Citation

Torregrosa, J-V, et al. "Evolution of Secondary Hyperparathyroidism After Kidney Transplantation in Patients Receiving Cinacalcet On Dialysis." Transplantation Proceedings, vol. 41, no. 6, 2009, pp. 2396-8.
Torregrosa JV, Bergua C, Martinez de Osaba MJ, et al. Evolution of secondary hyperparathyroidism after kidney transplantation in patients receiving cinacalcet on dialysis. Transplant Proc. 2009;41(6):2396-8.
Torregrosa, J. V., Bergua, C., Martinez de Osaba, M. J., Oppenheimer, F., & Campistol, J. M. (2009). Evolution of secondary hyperparathyroidism after kidney transplantation in patients receiving cinacalcet on dialysis. Transplantation Proceedings, 41(6), 2396-8. https://doi.org/10.1016/j.transproceed.2009.06.073
Torregrosa JV, et al. Evolution of Secondary Hyperparathyroidism After Kidney Transplantation in Patients Receiving Cinacalcet On Dialysis. Transplant Proc. 2009 Jul-Aug;41(6):2396-8. PubMed PMID: 19715931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolution of secondary hyperparathyroidism after kidney transplantation in patients receiving cinacalcet on dialysis. AU - Torregrosa,J-V, AU - Bergua,C, AU - Martinez de Osaba,M J, AU - Oppenheimer,F, AU - Campistol,J M, PY - 2009/9/1/entrez PY - 2009/9/1/pubmed PY - 2010/1/12/medline SP - 2396 EP - 8 JF - Transplantation proceedings JO - Transplant Proc VL - 41 IS - 6 N2 - BACKGROUND: Secondary hyperparathyroidism (SHPT) is a relevant problem in patients undergoing dialysis, and cinacalcet hydrochloride seems to be the best option for controlling it. After kidney transplantation (KTx), moderate to severe SHPT may persist and cause hypercalcemia and hypophosphatemia, among other deleterious effects. The number of patients receiving cinacalcet before KTx is increasing. OBJECTIVE: To evaluate the evolution of calcemia, phosphatemia, and intact parathyroid hormone (iPTH) after KTx in patients with SHPT receiving cinacalcet on dialysis. PATIENTS AND METHODS: The study included 19 patients (15 men and 4 women; mean [SD] age, 52 [13] years) undergoing dialysis and receiving cinacalcet before KTx. Mean duration of dialysis before KTx was 33 (25) months, and cinacalcet dose was 45 (15) mg/d. Creatinine, calcium, phosphorus, alkaline phosphatase, and iPTH concentrations were evaluated at baseline (day of surgery), at 15 days after surgery, and then monthly for 6 months. In all patients, cinacalcet therapy was discontinued on the day of surgery. RESULTS: After the first month post-KTx, mean (SD) serum creatinine concentration was 1.6 (0.4) mg/dL and remained stable during follow-up. Calcium and phosphorus concentrations were normal in 13 patients after KTx; however, in 6 patients, hypercalcemia (calcium concentration, 11 [1.3] mg/dL) or hypophosphatemia (phosphorus concentration, 1.7 [0.6] mg/dL) developed, with iPTH concentration of 557 (400) pg/mL and alkaline phosphatase concentration of 307 (114) IU/mL. Treatment with cinacalcet resulted in correction of calcium and phosphorus concentrations (10.1 [0.4] mg/dL and 1.7 [0.7] mg/dL, respectively). Patients in whom hypercalcemia or hypophosphatemia developed were receiving cinacalcet, 60 mg/d or more, during dialysis therapy. Patients who received cinacalcet, 30 mg/d, before KTx did not exhibit hypercalcemia or hypophosphatemia after KTx. CONCLUSION: In patients with HPT undergoing dialysis and receiving cinacalcet, 60 mg/d or more, this drug therapy should be continued after KTx to avert development of hypercalcemia or hypophosphatemia. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/19715931/Evolution_of_secondary_hyperparathyroidism_after_kidney_transplantation_in_patients_receiving_cinacalcet_on_dialysis_ DB - PRIME DP - Unbound Medicine ER -