[Cinacalcet in the treatment of secondary hyperparathyreoidism in a child with chronic kidney disease--case report].
The medical history and treatment of 2.5 years old girl with chronic kidney disease and heavy hyperparathyreoidism was presented in this case report. This girl was treated by peritoneal dialysis (APD) due to chronic kidney disease and congenital nephrotic syndrome. The secondary paraidothyreoidism was a reason of the epiphysial of the upper end of the femur, which appeared despite of the treatment by the Vitamin D3 (Calciphediol and Alphacalcidol) and phosphate binding drugs like Calcium Carbonate and Sevelamer. The primary laboratory tests were: Ca 9.32 mg/dl, Ca jon. 1.21 mmol/l, PO4 7.29 mg/dl, BE +4.9 mmol/l, ALP 1425 U/l, PTH 3774 pg/ml, Albumins 3.23 g/l, Hgb 8.2 g/l. The treatment of cinacalcet (Mimpara, 30 mg, Amgen) in dose of 15 mg was started because of lack of the standard therapy results. The laboratory tests were controlled after 2 weeks and then every week to 5th and every 2 weeks to the end. This therapy was finished after 30 weeks and only the standard therapy of hyperphosphatemia was continued. The laboratory tests 3 month after stopped the treatment were: Ca 10.5 mg/dl, Ca jon. 1.36 mmol/l, PO4 4.0 mg/dl, BE +4.9 mmol/l, ALP 312 U/l, PTH 134 pg/ml, Albumins 3.23 g/l, Hgb 9.9 g/l. There were any adverse events observed during the treatment.


CONCLUSIONS
It seems, the cinacalcet may be an alternate treatment to paraidectomy in children with chronic kidney disease and heavy secondary hyperparathyreoidism.
Runowski
Dariusz
D
Department of Pediatrics, Nephrology and Toxicology, District Hospital in Szczecin. runko@wp.pl
Jachimiak
Bozena
B
D002675:Child, Preschool; D002908:Chronic Disease; D002928:Cinanserin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology; D054559:Hyperphosphatemia / Q000188:drug therapy / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications*; D009404:Nephrotic Syndrome / Q000150:complications / Q000151:congenital / Q000628:therapy; D010530:Peritoneal Dialysis; D012702:Serotonin Antagonists / Q000627:therapeutic use
D012702:Serotonin Antagonists; D002928:Cinanserin