Evaluation of cinacalcet HCl treatment after kidney transplantation.
BACKGROUND
Hyperparathyroidism often remains or develops after kidney transplantation. Vitamin D sterol used as treatment for an elevated parathyroid hormone (PTH) level and associated bone disease may be contraindicated due to hypercalcemia. The calcimimetic cinacalcet HCl (cinacalcet), which lowers PTH and calcium (Ca) in chronic kidney disease patients, may represent an alternate therapeutic modality.


METHODS
This multicenter, retrospective, observational study examined 41 kidney transplant patients receiving cinacalcet for ≥3 months starting ≥3 months posttransplantation. Levels of intact PTH, Ca, and phosphorus (P) were examined during the assessment phase (3-6 months after initiation).


RESULTS
Median PTH decreased 21.8% during the assessment phase (P < .001), with 32.5% of patients exhibiting a ≥30% decrease in PTH from baseline. Median Ca decreased 6.8% (P < .0001). Median serum P rose 10.0% (P = .0124), but remained within normal limits. The estimated glomerular filtration rate was stable throughout the study.


CONCLUSIONS
Cinacalcet may be useful for the treatment of hyperparathyroidism after kidney transplantation. Randomized, prospectively designed clinical trials are required to confirm these results.
Copley
J B
JB
Cleveland Clinic Florida, Weston, Florida 33331, USA. brian.copley@bms.com
Germain
M
M
Stern
L
L
Pankewycz
O
O
Katznelson
S
S
Shah
T
T
Wang
O
O
Turner
S A
SA
Sprague
S M
SM
D000328:Adult; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D000069449:Cinacalcet; D005919:Glomerular Filtration Rate; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy*; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D016030:Kidney Transplantation / Q000009:adverse effects*; D009281:Naphthalenes / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D018579:Patient Selection; D011183:Postoperative Complications / Q000188:drug therapy; D012189:Retrospective Studies
D009281:Naphthalenes; D010281:Parathyroid Hormone; D000069449:Cinacalcet