title: Effect of cinacalcet cessation on hyperparathyroidism in kidney transcaplant patients after long-term dialysis therapy.
abstract: BACKGROUND
  Cinacalcet is a promising therapy widely used in dialysis patients with hyperparathyroidism resistant to conventional therapy. However, reports regarding the influence of cinacalcet cessation after long-term use on kidney transplantation patients are few.
  
  
  METHODS
  This retrospective observational study included 40 dialysis patients who underwent kidney transplantation. Creatinine, corrected calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone levels were assessed before and after kidney transplantation according to pretransplant treatment of chronic kidney disease-mineral and bone disorder.
  
  
  RESULTS
  Ultrasonography revealed enlargement of the parathyroid in all patients treated with cinacalcet. Although the data at the time of kidney transplantation were comparable, the serum levels of calcium, alkaline phosphatase, and intact parathyroid hormone after kidney transplantation were higher in patients treated with cinacalcet than in those treated without. However, serum phosphate levels in the cinacalcet group were slightly higher at the time of kidney transplantation and significantly lower 3 months later.
  
  
  CONCLUSIONS
  Mineral abnormalities persisted in kidney transplant patients with enlarged parathyroid glands after discontinuation of cinacalcet treatment. Parathyroidectomy should be considered in kidney transplant candidates with the risk of developing refractory hyperparathyroidism after transplantation.
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. fhideki@med.kobe-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Yoshikawa
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Kono
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Yonekura
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Goto
authors.affiliation: Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishimura
authors.affiliation: Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takeda
authors.affiliation: Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D000328:Adult; D057966:Calcimimetic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000069449:Cinacalcet / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000097:blood; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000378:metabolism; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood
chemical_list: D057966:Calcimimetic Agents; D008903:Minerals; D010281:Parathyroid Hormone; D014807:Vitamin D; D000069449:Cinacalcet
keywords: Cinacalcet; Hyperparathyroidism; Kidney transplantation; Parathyroid hormone; Vitamin D