title: Decreases in parathyroid gland volume after cinacalcet treatment in hemodialysis patients with secondary hyperparathyroidism.
abstract: OBJECTIVE
  Cinacalcet, an allosteric modulator of the calcium-sensing receptor, effectively reduces serum parathyroid hormone (PTH). It was examined whether a regression of parathyroid glands in hemodialysis patients with secondary hyperparathyroidism was induced by cinacalcet treatment.
  
  
  METHODS
  Ultrasonography of the parathyroid glands was performed to examine the changes in the parathyroid gland volumes after cinacalcet treatment in 58 patients.
  
  
  RESULTS
  After cinacalcet treatment, serum calcium, phosphate, alkaline phosphatase, and intact PTH significantly decreased (p < 0.0001). The total volumes of the parathyroid glands were significantly decreased 6 months after cinacalcet treatment (942 +/- 747 vs. 708 +/- 550 mm(3), p < 0.0005). There was a significant positive correlation between the parathyroid gland volumes at the start of cinacalcet treatment and the volume reduction in parathyroid glands (r = 0.716, p < 0.0001). Of the 58 patients, the total parathyroid gland volume was decreased in 42 patients and increased in 16 although the doses of cinacalcet, phosphate binders or vitamin D were not significantly different. In both groups, the intact PTH serum levels were significantly decreased after cinacalcet treatment.
  
  
  CONCLUSIONS
  Cinacalcet treatment in patients with secondary hyperparathyroidism significantly reduced the total parathyroid gland volume in a short 6-month period. This study suggests that cinacalcet treatment may postpone parathyroidectomy and/or reduce cases.
authors.affiliation: Department of Endocrinology, Metabolism, and Molecular Medicine, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ichii
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Senji
authors.initials: S
authors.lastname: Okuno
authors.forename: Hidenori
authors.initials: H
authors.lastname: Chou
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kato
authors.forename: Naoki
authors.initials: N
authors.lastname: Tsuboniwa
authors.forename: Kyoko
authors.initials: K
authors.lastname: Nagasue
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maekawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D000368:Aged; D000069449:Cinacalcet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000494:pharmacology / Q000627:therapeutic use*; D009929:Organ Size / Q000187:drug effects; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*; D011446:Prospective Studies; D006435:Renal Dialysis; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D009281:Naphthalenes; D000069449:Cinacalcet