title: Renal function in patients treated with cinacalcet for persistent hyperparathyroidism after kidney transplantation.
abstract: OBJECTIVE
  Cinacalcet effectively reduces calcium in patients with persistent hyperparathyroidism (HPT) after kidney transplantation. We aimed to assess the association of cinacalcet with a decrease in renal function based on a meta-analysis of observational studies in kidney transplant patients with persistent HPT.
  
  
  METHODS
  Meta-analysis of observational studies, no randomized controlled studies were available. We calculated the mean difference between renal function before cinacalcet and at 3 months on cinacalcet treatment for each study. Pooled analyses are based on random effects models.
  
  
  RESULTS
  Pooling the studies on kidney transplant patients with persistent HPT (8 studies, n = 115), we found a significant reduction in renal function (p = 0.008). The effect size was 5 μmol/l (p < 0.0001) when pooling the 7 studies where serum creatinine levels were reported. Meta-regression analysis revealed that there was an association between renal function and the amount of calcium reduction under treatment with cinacalcet. A higher delta change in serum calcium levels was associated with a decrease in renal function at 3 months of cinacalcet treatment.
  
  
  CONCLUSIONS
  Cinacalcet treatment was associated with a decline of renal function in kidney transplant recipients with persistent HPT. Our meta-analysis underscores the need for frequent monitoring of creatinine and calcium levels during cinacalcet treatment.
authors.affiliation: Center on Aging and Mobility, University Hospital, University of Zürich, Rämistrasse 100, Switzerland.
authors.forename: Jana
authors.initials: J
authors.lastname: Henschkowski
authors.forename: Heike A
authors.initials: HA
authors.lastname: Bischoff-Ferrari
authors.forename: Rudolf P
authors.initials: RP
authors.lastname: Wüthrich
authors.forename: Andreas L
authors.initials: AL
authors.lastname: Serra
mesh_terms: D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D003404:Creatinine / Q000097:blood; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy* / Q000503:physiopathology; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D009281:Naphthalenes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D009281:Naphthalenes; D003404:Creatinine; D002118:Calcium; D000069449:Cinacalcet