title: Continuation of cinacalcet immediately after renal transplantation: a prospective cohort study.
abstract: BACKGROUND
  Cinacalcet is used for treating secondary hyperparathyroidism in dialysis patients, but it is currently unknown whether it can safely be continued immediately after renal transplantation.
  
  
  METHODS
  We prospectively studied renal transplant recipients with secondary hyperparathyroidism who were receiving cinacalcet before transplantation and continued treatment afterwards (n = 29) at a dose of 30 mg/day. Cinacalcet dose was titrated to serum calcium. Patients were followed for 6 months. Incidence of hypercalcemia, serum calcium and intact PTH (iPTH) were analyzed. Tacrolimus levels, acute rejection rate and renal function were compared with an age and sex matched control group.
  
  
  RESULTS
  In 16 patients hypercalcemia was observed after transplantation. Severe hypercalcemia (>= 2.87 mmol/l) (n = 4) and hypocalcemia (n = 2) were infrequent. No difference in acute rejection rate or renal function between the cinacalcet and the control group was found. There also was no clinically relevant influence of cinacalcet on tacrolimus levels.
  
  
  CONCLUSIONS
  Our study shows that cinacalcet can safely be continued immediately after renal transplantation. Studies are needed to determine if continuation of cinacalcet is better than early withdrawal. Also, the optimum dose of cinacalcet and the long-term effects of cinacalcet after renal transplantation must be defined.
authors.affiliation: Department of Nephrology, Radboud University Nijmegen Medical Center, The Netherlands. j.aalten@nier.umcn.nl
authors.forename: J
authors.initials: J
authors.lastname: Aalten
authors.forename: J F M
authors.initials: JF
authors.lastname: Wetzels
authors.forename: A J
authors.initials: AJ
authors.lastname: Hoitsma
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D057966:Calcimimetic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D000069449:Cinacalcet; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage* / Q000009:adverse effects; D009426:Netherlands; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D057966:Calcimimetic Agents; D007166:Immunosuppressive Agents; D009281:Naphthalenes; C470125:PTH protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D002118:Calcium; D000069449:Cinacalcet