[Cinacalcet in the management of normocalcaemic secondary hyperparathyroidism after kidney transplantation: one-year follow-up multicentre study].
BACKGROUND
The effect of cinacalcet in patients with persistent secondary hyperparathyroidism (SHPT) after kidney transplantation (RT) has mainly been reported in patients with secondary hypercalcaemia.


OBJECTIVE
Our objective was to assess the long-term effect of cinacalcet on patients with a RT and normocalcaemic SHPT.


METHODS
A one-year multicentre, observational, retrospective study that included kidney recipients with SHPT (intact parathyroid hormone [iPTH] >120 pg/ml) and calcium levels within the normal range (8.4-10.2 mg/dl). Patients began treatment with cinacalcet in clinical practice.


RESULTS
32 patients with a mean age (standard deviation [SD]) of 54 (11) years, 56% male, were included in the study. Treatment with cinacalcet began a median of 16 months after RT (median dose of 30 mg/day). Levels of iPTH decreased from a median (P25, P75) of 364 (220, 531) pg/ml at the start of the study to 187 (98, 320) after 6 months (48.6% reduction, P=.001) and to 145 (91, 195) after 12 months (60.2% reduction, P=.001), without there being changes in calcium and phosphorus levels (P=.214 and P=.216, respectively). No changes were observed in kidney function or anti-calcineuric drug levels. 3.1% of patients discontinued cinacalcet due to intolerance and 6.2% due to a lack of efficacy.


CONCLUSIONS
In patients with normocalcaemic SHPT after RT, cinacalcet improves the control of serum PTH values without causing changes to calcaemia, phosphataemia or kidney function. Cinacalcet showed good tolerability.
Josep V
JV
Torregrosa
Enrique
E
Morales
Juan M
JM
Díaz
Josep
J
Crespo
Juan
J
Bravo
Gonzalo
G
Gómez
Miguel A
MA
Gentil
Alberto
A
Rodríguez-Benot
Minerva
M
Rodríguez-García
Verónica
V
López-Jiménez
Álex
Á
Gutiérrez-Dalmau
Luisa
L
Jimeno
M José
MJ
Pérez-Sáez
Rafael
R
Romero
Carlos
C
Gómez-Alamillo
D000069449:Cinacalcet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors
D009281:Naphthalenes; D000069449:Cinacalcet