title: Cinacalcet improves bone density in post-kidney transplant hyperparathyroidism.
abstract: The recent availability of cinacalcet has provided a possible alternative to parathyroidectomy in kidney transplant patients with persistent hyperparathyroidism, but its effect on bone mass density (BMD) is unknown. From our database containing 163 kidney transplants performed at our center from 1999 to 2007, we compared recipients who received cinacalcet for persistent hypercalcemia and hyperparathyroidism following renal transplantation (n = 8) with up to two other posttransplant patients matched for age, sex, race, and graft function (n = 15). The outcome of the study was BMD changes from baseline to 12, 24, and 36 months post-renal transplantation. Repeated-measures mixed model was used to assess the difference of BMD change between two groups. Cinacalcet therapy was started at a median of 9 (range = 1 to 24) months posttransplant with a mean dose 56 ± 29 mg/d (mean duration = 1.6; range = 1 to 2.1 years). Cinacalcet therapy was associated with significant reduction of serum calcium compared to control. Cinacalcet therapy was associated with greater BMD increase at the hip over the 36-month posttransplant period. Cinacalcet was well tolerated. Our results suggest that cinacalcet may have a small but favorable effect on bone density following kidney transplantation.
authors.affiliation: Kidney Disease Branch, NIDDK, Clinical Center, NIH, Bethesda, Maryland 20892, USA. moniquec@intra.niddk.nih.gov
authors.forename: M E
authors.initials: ME
authors.lastname: Cho
authors.forename: Z
authors.initials: Z
authors.lastname: Duan
authors.forename: C E
authors.initials: CE
authors.lastname: Chamberlain
authors.forename: J C
authors.initials: JC
authors.lastname: Reynolds
authors.forename: M S
authors.initials: MS
authors.lastname: Ring
authors.forename: R B
authors.initials: RB
authors.lastname: Mannon
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D050280:Arm Bones / Q000000981:diagnostic imaging / Q000187:drug effects; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D057966:Calcimimetic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D000069449:Cinacalcet; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects / Q000627:therapeutic use*; D009316:National Institutes of Health (U.S.); D012189:Retrospective Studies; D013131:Spine / Q000000981:diagnostic imaging / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D015415:Biomarkers; D057966:Calcimimetic Agents; D009281:Naphthalenes; D002118:Calcium; D000069449:Cinacalcet