title: Marked increase in bone formation markers after cinacalcet treatment by mechanisms distinct from hungry bone syndrome in a haemodialysis patient.
abstract: A 59-year-old female who was on dialysis due to diabetic nephropathy was referred to our hospital for severe hyperparathyroidism refractory to intravenous vitamin D receptor activator treatment. With subsequent cinacalcet hydrochloride treatment, parathyroid hormone (PTH) levels were only slightly suppressed. However, progressive increases were observed in serum alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) levels with mild hypocalcaemia. A bone biopsy, obtained immediately before surgical parathyroidectomy after 3 months of cinacalcet treatment, revealed no disappearance of osteoclasts. These data suggest that cinacalcet hydrochloride treatment may induce a marked promotion of bone formation by mechanisms distinct from hungry bone syndrome that usually develops after parathyroidectomy.
authors.affiliation: Division of Nephrology and Kidney Center , Kobe University School of Medicine , Kobe.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Goto
authors.affiliation: Division of Nephrology and Kidney Center , Kobe University School of Medicine , Kobe.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Matsui-clinic, Akashi , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Division of Nephrology and Kidney Center , Kobe University School of Medicine , Kobe.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
keywords: bone formation; cinacalcet hydrochloride; secondary hyperparathyroidism