Effects of cinacalcet on gastrointestinal hormone release in patients with secondary hyperparathyroidism undergoing dialysis.
Objective. Our aim has been evaluating the influence of an acute dose of cinacalcet on the gastrointestinal hormonal responses to a test meal in uraemic patients with secondary hyperparathyroidism undergoing peritoneal dialysis (PD) or haemodialysis (HD).


METHODS
Twenty patients (11 PD, 9 HD) on cinacalcet treatment (30-120 mg/day) were studied. Twelve patients (1 PD, 11 HD) who never received cinacalcet were studied as control group. Each patient received a test meal with blood samples at 0, 2 and 4 h. At 0 time, patients in the cinacalcet group received their usual oral dose of this calcimimetic. Plasma concentrations of intact parathyroid hormone (PTH), vasoactive intestinal peptide (VIP), ghrelin, substance P, serotonin, cholecystokinin (CCK) and gastrin were quantified at 0, 2 and 4 h.


RESULTS
No significant differences in baseline concentrations of serum VIP, ghrelin, substance P, serotonine, CCK and gastrin were found between controls and cinacalcet-treated patients. In comparison with the control group, cinacalcet administration was followed by a significant decrease in VIP concentration at 4 h and a significant increase in substance P at 4 h. However, the areas under the curves of all studied gut hormones were similar in both groups.


CONCLUSIONS
An acute dose of cinacalcet exerts minimal influence on gut hormone responses to a mixed meal in dialysis patients on chronic therapy with this drug. The small but significant differences between control subjects and patients on cinacalcet in VIP and substance P levels at 4 h should be investigated in symptomatic patients.
Department of Endocrinology, Hospital Ramón y Cajal, Carretera de Colmenar km 9, 28034 Madrid, Spain. mibarsd@infomed.es
Juan J
JJ
Díez
Jose Luis
JL
Miguel
Rosa
R
Codoceo
Pedro
P
Iglesias
M Auxiliadora
MA
Bajo
Carmen
C
Sánchez
Gloria
G
Del Peso
Fernando
F
Gil
Jorge
J
Martinez-Ara
Pilar González
PG
Gancedo
Rafael
R
Selgas
D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D004305:Dose-Response Relationship, Drug; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005768:Gastrointestinal Hormones / Q000378:metabolism*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011863:Radioimmunoassay; D006435:Renal Dialysis / Q000379:methods*; D012720:Severity of Illness Index; D013373:Substance P / Q000097:blood; D016896:Treatment Outcome; D014660:Vasoactive Intestinal Peptide / Q000097:blood
D005768:Gastrointestinal Hormones; D009281:Naphthalenes; D010281:Parathyroid Hormone; D010758:Phosphorus; D013373:Substance P; D014660:Vasoactive Intestinal Peptide; D002118:Calcium; D000069449:Cinacalcet