The treatment of secondary hyperparathyroidism in haemodialysis patients' refractory to alfacalcidol

Autor: N I Sazonova, V.Yu. Shilo Shilo, T O ChERNOVA, L. V. Egshatyan, A I Mordik, I V Kim, N S Kuznetsov, A V Il'in, L. Ya. Rozhinskaya, O V Remizov, A M Artemova, A. I. Bukhman, A V Pushkina, V N Borisov
Rok vydání: 2012
Předmět:
Zdroj: Эндокринная хирургия, Vol 6, Iss 2, Pp 27-41 (2012)
ISSN: 2310-3965
2306-3513
DOI: 10.14341/2306-3513-2012-2-27-41
Popis: Background. Secondary hyperparathyroidism (sHPT) is one of the serious complications in chronic kidney disease and is associated with progressive bone disease and vascular calcification.The objective of the study was to determine the impact of Mimpara (Cinacalcet HCl) on mineral disorder, bone turnover and bone mineral density (BMD) versus parathyroidectomy (PTx) in haemodialysis patients’ refractory to alfacalcidol. Materials and methods. 62 haemodialysis patients with sHPT were enrolled in this 6=months prospective study. All of them had surgical indications for PTx. Surgical indications was established according to clinical or biological assessment. 40 patients underwent Mimpara treatment. Dose of Mimpara was titrated every 4 weeks. Sequential doses included 30–180 (mean 59.1 ± 34.2) mg/day. 22 patients underwent PTx. The surgical technique was depended on quantity of hyperplastic parathyroid glands.Results. In 6 months mean iPTH, Ca, Са×Р, CTx and OC levels significantly decreased by 55.7%, 13.8%,34.3%, 21.4 and 1.4% in the Mimpara group vs. 90.7%, 14%, 55.5%, 58.7% and 26.9% in the PTx group. Median serum iPTH level decreased by 30% after initiation of Mimpara in 94.3% patients, from them by 50%in 74.3%. Achieved the KDOQI treatment targets for PTH in 28.6% patients.In 6 months after PTx median serum iPTH level was
Databáze: OpenAIRE