title: [The influence of side effects related to cinacalcet therapy on compliance in hemodialysis patients suffering from secondary hyperparathyroidism].
abstract: BACKGROUND
  Secondary hyperparathyroidism (sHPT) in hemodialysis patients often requires an introduction of calcimimetic (cinacalcet) therapy. This medication effectively reduces parathormon (iPTH) serum concentration and modifies calcium phosphorus score, however its oral administration often implicates the occurrence of side effects which may worsen adherence to this medication. The aim of the study was to asses the influence of cinacalcet therapy side effects on patients adherence to the regiment prescription in hemodialysis patients suffering from secondary hyperparathyroidism
  
  
  METHODS
  Fifty six participants (male 26 and 30 female) in age of 36-75 years, on maintenance hemodialysis 3 times a week, mean session time 4 hours and 25 minutes, treated with orally administered cinacalcet due to sHPT, were involved in the study. The initial dose 30 mg was modified once a visit (an increase or a decrease of 30 mg, if necessary) according to serum iPTH--cinacalcet maximal mean dose was 86 mg. During the treatment any presence of cinacalcet side effect and its intensity was noted. Patients'adherence to medication basing on medication intake were calculated and over 70% intake of cinacalcet doses was regarded as the good adherence.
  
  
  RESULTS
  Twenty eight of 56 participants treated with cinacalcet were excluded mainly due to non-compliance. In the cohort, a total number of 70 cases of side effects were noted. In patients who resigned of the treatment the occurrence of cinacalcet adverse events (AE) was not higher than in participants continuing therapy (p > 0.05). Additionally in this group sever AE due to hypocalcaemia i.e. paresthesia, weakness, was rarely reported. In patients with good adherence side effects were presented with similar incidence in comparison to non-compliance patients.
  
  
  CONCLUSIONS
  The incidence of cinacalcet adverse events was regarded as the factor which had an insignificant influence on patients'adherence to this medication. Therefore, it is essential to monitor patients'compliance to decrease non-adherence episodes.
authors.affiliation: Zakład Transplantologii Nerek, Uniwersytet Medyczny w Łodzi. rafal.zwiech@umed.lodz.pl
authors.forename: Rafał
authors.initials: R
authors.lastname: Zwiech
authors.forename: Sławomir
authors.initials: S
authors.lastname: Chrul
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D057966:Calcimimetic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006996:Hypocalcemia / Q000139:chemically induced; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000139:chemically induced; D009281:Naphthalenes / Q000008:administration & dosage / Q000009:adverse effects*; D010281:Parathyroid Hormone / Q000097:blood; D010292:Paresthesia / Q000139:chemically induced; D010349:Patient Compliance / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D057966:Calcimimetic Agents; D009281:Naphthalenes; D010281:Parathyroid Hormone; D000069449:Cinacalcet