Treatment With Cinacalcet of Secondary Hyperparathyroidism After Renal Transplantation
| Autor: | A. Vilar Gimeno, M.J. Pascual Felip, M.A. Munar Vila, G Gómez Marqués, A. Obrador Mulet, P. Losada González, M Uriol Rivera, M. Molina Guasch, A. Alarcón Zurita |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Cinacalcet Adolescent Calcitriol Calcimimetic Urology Parathyroid hormone Naphthalenes Young Adult Postoperative Complications Internal medicine medicine Humans Vitamin D Aged Retrospective Studies Transplantation Hyperparathyroidism business.industry Phosphorus Middle Aged medicine.disease Kidney Transplantation Endocrinology medicine.anatomical_structure Hypercalcemia Female Hyperparathyroidism Secondary Surgery Secondary hyperparathyroidism Parathyroid gland business Immunosuppressive Agents hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Transplantation Proceedings. 41:2139-2143 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2009.06.090 |
| Popis: | Background. The treatment of posttransplant secondary hyperparathyroidism (SHP) with vitamin D analogues is determined by their effectiveness to reverse hypercalcemia. Calcimimetics inhibit parathyroid hormone (PTH) secretion by modulating the calcium-sensing receptor in the parathyroid gland. Cinacalcet, a calcimimetic drug, has proven its effectiveness for the treatment of SHP among patients in phase V of chronic renal disease. Patients and Methods. This retrospective analysis included 48 patients with SHP who were treated with cinacalcet. The initial dose of 30 mg/d could be increased to 180 mg, administering calcitriol also, depending on the serum calcium and PTH levels. The objectives were a PTH level between 75 and 125 pg/mL or a decrease >40%, and a serum calcium level below 10.5 mg/dL. Results. The average PTH at baseline was 244 pg/mL, decreasing to 131 pg/mL at 1 year (P < .01). The average calcium at baseline was 10.1 mg/dL descending to 9.2 mg/dL at 1 year (P < .01). Among patients with hypercalcemia, the calcium decreased from 11 to 9.6 mg/dL at 1 year (P < .01). Seventy percent of patients without hypercalcemia reached the desired value of PTH, and 100% of those with hypercalcemia. Among patients with hypercalcemia, the desired calcium level was reached in 91% of cases. Ten patients developed hypocalcemia. In 3 cases we stopped the treatment with cinacalcet due to digestive intolerance. Conclusions. Treatment with cinacalcet controlled hyperparathyroidism and hypercalcemia among patients with posttransplant SHP. It was a safe drug, with a low incidence of side effects. |
| Databáze: | OpenAIRE |
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