title: Cinacalcet decreases bone formation rate in hypercalcemic hyperparathyroidism after kidney transplantation.
abstract: OBJECTIVE
  Cinacalcet reduces serum calcium in kidney transplant recipients with hypercalcemic hyperparathyroidism. Its effect on bone, however, has not been investigated in this population.
  
  
  METHODS
  We prospectively examined bone turnover, histomorphometry and density as well as serum bone biomarkers in 10 transplant recipients before and after treatment with cinacalcet.
  
  
  RESULTS
  After 18-24 months of treatment with cinacalcet, bone formation decreased in 7, increased in 2, and remained zero in 1 patient (p = 0.11). Trabecular bone volume was maintained. Trabecular number decreased (p = 0.03), but trabecular thickness was unchanged (p = 0.17). Osteoid decreased (p = 0.02) and osteoblast surface increased (p = 0.02). Bone mineral density of the femur remained stable in 1 patient, decreased in 2 patients, but increased in 7 patients (p = 0.153). Serum calcium concentration (p = 0.005), iPTH (p = 0.01) and calcitonin concentration decreased (p = 0.03), while 25(OH) vitamin D(3) increased (p = 0.02). No fractures were reported. Graft function remained stable.
  
  
  CONCLUSIONS
  While cinacalcet might decrease bone formation rate, it did not change bone volume, and bone mineral density of the femur increased. Therefore, the use of cinacalcet in hypercalcemic hyperparathyroidism might be safe with regard to the bone disease present after kidney transplantation.
authors.affiliation: Department of Medicine III, Medical University Vienna, Austria. kyra.borchhardt@meduniwien.ac.at
authors.forename: Kyra A
authors.initials: KA
authors.lastname: Borchhardt
authors.forename: Danielle
authors.initials: D
authors.lastname: Diarra
authors.forename: Irene
authors.initials: I
authors.lastname: Sulzbacher
authors.forename: Thomas
authors.initials: T
authors.lastname: Benesch
authors.forename: Martin
authors.initials: M
authors.lastname: Haas
authors.forename: Gere
authors.initials: G
authors.lastname: Sunder-Plassmann
mesh_terms: D000368:Aged; D015519:Bone Density; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy* / Q000209:etiology; D006961:Hyperparathyroidism / Q000188:drug therapy* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000494:pharmacology*; D010012:Osteogenesis / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D009281:Naphthalenes; D000069449:Cinacalcet