Use of cinacalcet HCl to achieve the recommended targets of bone metabolism in a patient with therapy-resistant renal hyperparathyroidism.
We report on a patient with end-stage renal disease and severe progressive secondary hyperparathyroidism, whose condition failed to respond to conventional pharmacologic or surgical interventions. Although immunotherapy produced a partial response, it failed to decrease serum parathyroid hormone to the levels recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative clinical practice guidelines. Treatment with a new calcimimetic agent, cinacalcet HCl (Mimpara, Amgen, Munich, Germany), resulted in a rapid decline in elevated parathyroid hormone levels, near normalization of other laboratory markers of bone metabolism, improvement in mobility and skeletal pain caused by renal osteodystrophy, and an increase in body weight.
Bahner
Udo
U
KfH-Nierenzentrum Wuerzburg, Dialysis Unit, Würzburg, Germany. udo.bahner@kfh-dialyse.de
Brandl
Margit
M
Nies
Christoph
C
Schmidt-Gayk
Heinrich
H
D000328:Adult; D001851:Bone Diseases, Metabolic / Q000188:drug therapy*; D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D009281:Naphthalenes / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood*; D006435:Renal Dialysis; D016896:Treatment Outcome; D015430:Weight Gain
D009281:Naphthalenes; D010281:Parathyroid Hormone; D002118:Calcium; D000069449:Cinacalcet