Author/Editor     Borštnar, S; Eržen, B; Gmeiner-Stopar, T; Kocjan, T; Arnol, M; Kandus, A; Kovač, D
Title     Treatment of hyperparathyroidism with cinacalcet in kidney transplant recipients
Type     članek
Source     Transplant Proc
Vol. and No.     Letnik 42, št. 10
Publication year     2010
Volume     str. 4078-82
Language     eng
Abstract     Background: After successful kidney transplantation, hyperparathyroidism can persist in 10%-50% of patients and can harmfully affect bone metabolism. Calcimimetic cinacalcet is a new treatment option in the management of persistent hyperparathyroidism in these patients. Methods: This prospective, clinical study of 11 patients included those who had a serum intact parathyroid hormone (iPTH) concentration >65 ng/L, a serum creatinine concentration was <200 mumol/L, stable kidney graft function, and were >1 year since transplantation. Patients were not treated with drugs other than calcitriol that could influence bone metabolism. During the 6-month observation period, in which the stability of measured parameters was determined, and in the 12-month treatment period (cinacalcet 30 mg/d), we followed serum concentrations of calcium, phosphate, iPTH, creatinine, vitamin 25OH D(3), bone-specific alkaline phosphatase (ALP), osteocalcin, collagen degradation fragments (CTX), urinary calcium excretion, and bone mineral density (BMD). Results: During the treatment period, the serum calcium concentration decreased significantly (from 2.50 +/- 0.12 to 2.32 +/- 0.12 mmol/L; P < .01). Serum iPTH concentration decreased significantly (from 247 [range, 199-362] at time 0 to 198 [range, 165-233] ng/L after 1 month of treatment; P < .05), but increased slightly thereafter. After 6 months of treatment, the serum concentration of ALP and CTX increased significantly, but decreased thereafter. There were no significant changes in the other parameters assessed. Renal function remained stable during the treatment period. The BMD of the lumbar spine, hip, and forearm did not change during the 12 months of treatment. Conclusion: Cinacalcet was effective in treating posttransplant hyperparathyroidism, resulting in decreased calcemia and transient decreased iPTH. (Abs. trunc. at 2000 ch.)
Descriptors     HYPERPARATHYROIDISM
CALCITRIOL
KIDNEY TRANSPLANTATION
CREATINE
PARATHYROID HORMONES
CALCIUM
PROSPECTIVE STUDIES