title: Cinacalcet effects on the perioperative course of patients with secondary hyperparathyroidism.
abstract: OBJECTIVE
  Since its registration in 2004, the calcimimetic agent cinacalcet has been established as an alternative treatment for secondary hyperparathyroidism (SHPT). Working by allosteric activation of the calcium-sensing receptor, cinacalcet can lower parathyroid hormone (PTH) and calcium (Ca) in patients with SHPT. The influence of calcimimetics on the perioperative course has been unclear so far.
  
  
  METHODS
  We retrospectively analyzed the data of patients with primary operation for SHPT between 2004 and 2011, comparing the perioperative course of patients with and without preoperative cinacalcet treatment.
  
  
  RESULTS
  Fifty-six patients had cinacalcet therapy, and 54 patients had no calcimimetic medication prior to surgery. Gender, age, hemodialysis, and medical treatment were similar in both groups. Also, PTH levels were similar preoperatively and postoperatively (preoperative, 1,249 ± 676 vs. 1,196 ± 601 pg/ml; postoperative, 86 ± 220 vs. 62 ± 91 pg/ml). Patients with cinacalcet preoperatively had significant lower Ca levels preoperatively (2.49 ± 0.25 vs. 2.61 ± 0.24 mmol/l) and postoperatively (1.75 ± 0.37 vs. 1.86 ± 0.35 mmol/l) and had a higher rate of oral Ca substitution postoperatively (93 vs. 74 %). The risk for postoperative persistent disease was slightly higher in these patients compared to those without preoperative cinacalcet therapy (5 vs. 0 %, not significant).
  
  
  CONCLUSIONS
  In our experience, cinacalcet did not alter the perioperative course in SHPT patients.
authors.affiliation: Department of Visceral and Endocrine Surgery, Lukaskrankenhaus Neuss, Preussenstr. 84, 41464 Neuss, Germany. dwirowski@lukasneuss.de
authors.forename: Denis
authors.initials: D
authors.lastname: Wirowski
authors.forename: Peter E
authors.initials: PE
authors.lastname: Goretzki
authors.forename: Katharina
authors.initials: K
authors.lastname: Schwarz
authors.forename: Bernhard J
authors.initials: BJ
authors.lastname: Lammers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057966:Calcimimetic Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D006996:Hypocalcemia / Q000097:blood; D016030:Kidney Transplantation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis; D011300:Preoperative Care; D012189:Retrospective Studies; D013965:Thyroidectomy
chemical_list: D057966:Calcimimetic Agents; D009281:Naphthalenes; D010281:Parathyroid Hormone; D002118:Calcium; D000069449:Cinacalcet