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Effect of cinacalcet on renal electrolyte handling and systemic arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism.
Transplantation. 2011 Oct 27; 92(8):883-9.T

Abstract

BACKGROUND

The calcimimetic cinacalcet has recently been increasingly used for persistent hyperparathyroidism after renal transplantation. The present study investigated the short-term effects of cinacalcet on urinary electrolyte concentration and arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism.

METHODS

In a prospective controlled single-center cross-over study, we examined 10 stable kidney transplant patients (mean estimated glomerular filtration rate 51±10 mL/min/1.73 m(2)) who received cinacalcet daily for persistent hyperparathyroidism. Urine specimens were collected at baseline and every 2 hr for a total study period of 6 hr after ingestion of 30 mg cinacalcet and without cinacalcet. Intact parathyroid hormone was determined at baseline and 2 hr later. Using ambulatory blood pressure measurement, arterial blood pressure was determined every 15 min.

RESULTS

Intact parathyroid hormone was significantly reduced with cinacalcet as compared with controls (-37±27.7% vs. -9.6±10.3%, P=0.009). With cinacalcet, urinary calcium and magnesium concentration were increased (P=0.042 and P=0.007, respectively) and differed significantly as compared with the control phase without cinacalcet. After 4 hr, an increased urinary sodium concentration was also found compared with the control phase (P=0.039). Systolic blood pressure was reduced with cinacalcet (P<0.001) and differed significantly from control phase (-13.7±9.9 mm Hg vs. -3.2±5.2 mm Hg after 2 hr, P=0.009; -18.1±10.8 mm Hg vs. -1.9±5.2 mm Hg after 4 hr, P=0.001).

CONCLUSIONS

In the short term, cinacalcet increases the urinary concentration of calcium, magnesium, and sodium. The observed antihypertensive effect might be beneficial in patients with a high cardiovascular risk after kidney transplantation.

Authors+Show Affiliations

Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21876476

Citation

Zitt, Emanuel, et al. "Effect of Cinacalcet On Renal Electrolyte Handling and Systemic Arterial Blood Pressure in Kidney Transplant Patients With Persistent Hyperparathyroidism." Transplantation, vol. 92, no. 8, 2011, pp. 883-9.
Zitt E, Woess E, Mayer G, et al. Effect of cinacalcet on renal electrolyte handling and systemic arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism. Transplantation. 2011;92(8):883-9.
Zitt, E., Woess, E., Mayer, G., & Lhotta, K. (2011). Effect of cinacalcet on renal electrolyte handling and systemic arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism. Transplantation, 92(8), 883-9. https://doi.org/10.1097/TP.0b013e31822d87e8
Zitt E, et al. Effect of Cinacalcet On Renal Electrolyte Handling and Systemic Arterial Blood Pressure in Kidney Transplant Patients With Persistent Hyperparathyroidism. Transplantation. 2011 Oct 27;92(8):883-9. PubMed PMID: 21876476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of cinacalcet on renal electrolyte handling and systemic arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism. AU - Zitt,Emanuel, AU - Woess,Erich, AU - Mayer,Gert, AU - Lhotta,Karl, PY - 2011/8/31/entrez PY - 2011/8/31/pubmed PY - 2011/12/13/medline SP - 883 EP - 9 JF - Transplantation JO - Transplantation VL - 92 IS - 8 N2 - BACKGROUND: The calcimimetic cinacalcet has recently been increasingly used for persistent hyperparathyroidism after renal transplantation. The present study investigated the short-term effects of cinacalcet on urinary electrolyte concentration and arterial blood pressure in kidney transplant patients with persistent hyperparathyroidism. METHODS: In a prospective controlled single-center cross-over study, we examined 10 stable kidney transplant patients (mean estimated glomerular filtration rate 51±10 mL/min/1.73 m(2)) who received cinacalcet daily for persistent hyperparathyroidism. Urine specimens were collected at baseline and every 2 hr for a total study period of 6 hr after ingestion of 30 mg cinacalcet and without cinacalcet. Intact parathyroid hormone was determined at baseline and 2 hr later. Using ambulatory blood pressure measurement, arterial blood pressure was determined every 15 min. RESULTS: Intact parathyroid hormone was significantly reduced with cinacalcet as compared with controls (-37±27.7% vs. -9.6±10.3%, P=0.009). With cinacalcet, urinary calcium and magnesium concentration were increased (P=0.042 and P=0.007, respectively) and differed significantly as compared with the control phase without cinacalcet. After 4 hr, an increased urinary sodium concentration was also found compared with the control phase (P=0.039). Systolic blood pressure was reduced with cinacalcet (P<0.001) and differed significantly from control phase (-13.7±9.9 mm Hg vs. -3.2±5.2 mm Hg after 2 hr, P=0.009; -18.1±10.8 mm Hg vs. -1.9±5.2 mm Hg after 4 hr, P=0.001). CONCLUSIONS: In the short term, cinacalcet increases the urinary concentration of calcium, magnesium, and sodium. The observed antihypertensive effect might be beneficial in patients with a high cardiovascular risk after kidney transplantation. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/21876476/Effect_of_cinacalcet_on_renal_electrolyte_handling_and_systemic_arterial_blood_pressure_in_kidney_transplant_patients_with_persistent_hyperparathyroidism_ L2 - https://doi.org/10.1097/TP.0b013e31822d87e8 DB - PRIME DP - Unbound Medicine ER -