title: Two cases of acute renal hemorrhage undergoing maintenance hemodialysis after concurrent administration of cinacalcet.
abstract: We report here a rare complication of renal hemorrhage in 2 male patients under treatment with long-term hemodialysis subsequent to the administration of the calcimemetic agent, cinacalcet hydrochloride. The patients presented with flank pain, peripheral hypereosinophilia and severe anemia. Computed tomography revealed a massive subcapsular hematoma on the kidney. Extensive coagulation analyses were within normal ranges. They had not been administered new medication for their complications during the 6 months prior to admission, except for cinacalcet (Case 1, 14 days; Case 2, 13 days). A drug lymphocyte stimulating test for cinacalcet was positive in both cases. Eight percent of the patients in our hospital who were administered cinacalcet presented with complication of renal hemorrhage. Based on these findings, the final diagnosis was renal hemorrhage due to cinacalcet. They were treated conservatively because both the size of the hematoma and anemia improved. To the best of our knowledge, this is the first report concerning renal hemorrhage.
authors.affiliation: Division of Nephrology and Dialysis, Department of Internal Medicine, Nippon Kokan Fukuyama Hospital, 1844 Tsunoshita, Daimon-cho, Fukuyama, Hiroshima, 721-0927, Japan. kyw620@hotmail.co.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Wada
authors.affiliation: The 2nd Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Iino
mesh_terms: D000328:Adult; D057966:Calcimimetic Agents / Q000009:adverse effects*; D000069449:Cinacalcet; D006406:Hematoma / Q000209:etiology*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects*; D011860:Radiography, Abdominal; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed
chemical_list: D057966:Calcimimetic Agents; D009281:Naphthalenes; D000069449:Cinacalcet