title: Minimal impact of calcimimetics on the management of hyperparathyroidism in chronic dialysis.
abstract: BACKGROUND
  The calcimimetic drug cinacalcet has changed the prescription patterns in patients with secondary hyperparathyroidism, despite the lack of randomized studies that compare cinacalcet with conventional treatment, including parathyroidectomy. The aim of this study was to evaluate current management of patients on chronic dialysis with incidental and parathyroid hormone (PTH) levels ≥ 500 ng/L.
  
  
  METHODS
  Prospective pharmacoepidemiologic study of chronic dialysis patients with PTH level ≥ 500 ng/L.
  
  
  RESULTS
  We studied 269 patients. Among the 186 patients who had 2-year follow-up, 125 (67%) were managed using cinacalcet. At 2 years, when comparing the cinacalet with the noncinacalet groups, we found that mean PTH values were 400 ± 318 versus 388 ± 251 ng/L (P = ns) and the percentage of patients following 2009 PTH Kidney Disease Improving Global Outcomes (KDIGO) guidelines were 79 versus 85% (P = ns). Eight patients (4%) underwent parathyroidectomy. On multivariate analysis, the use of cinacalcet was not a predictor for PTH within KDIGO guidelines at 2-year follow-up.
  
  
  CONCLUSIONS
  Cinacalcet was used in the majority (67%) of patients on chronic dialysis with secondary hyperparathyroidism, but the use of cinacalcet did not affect mean PTH values nor the proportion of patients following KDIGO guidelines compared with patients not using calcimimetics.
authors.affiliation: University de Lorraine, CHU Nancy - Hospital Brabois Adultes, Department of Digestive, Hepato-Biliary and Endocrine Surgery, Nancy, France; INSERM U954, University de Lorraine, Faculty de medicine, Nancy, France. Electronic address: l.brunaud@chu-nancy.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.affiliation: University de Lorraine, CHU Nancy, Pôle S2R, Epidémiologie et Evaluation Cliniques, INSERM, CIC-EC1433, Nancy, France.
authors.forename: Willy
authors.initials: W
authors.lastname: Ngueyon Sime
authors.affiliation: University de Lorraine, CHU Nancy, Pôle S2R, Epidémiologie et Evaluation Cliniques, INSERM, CIC-EC1433, Nancy, France; University de Lorraine, CHU Nancy, Department of Nephrology, Nancy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Filipozzi
authors.affiliation: University de Lorraine, CHU Nancy - Hospital Brabois Adultes, Department of Digestive, Hepato-Biliary and Endocrine Surgery, Nancy, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Nomine-Criqui
authors.affiliation: Division of Endocrine and Minimally Invasive Surgery, Department of Surgery, Weill Cornell Medical College, New York, NY.
authors.forename: Anna
authors.initials: A
authors.lastname: Aronova
authors.affiliation: Division of Endocrine and Minimally Invasive Surgery, Department of Surgery, Weill Cornell Medical College, New York, NY.
authors.forename: Rasa
authors.initials: R
authors.lastname: Zarnegar
authors.affiliation: University de Lorraine, CHU Nancy, Department of Nephrology, Nancy, France.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kessler
authors.affiliation: University de Lorraine, CHU Nancy, Department of Nephrology, Nancy, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Frimat
authors.affiliation: University de Lorraine, CHU Nancy, Pôle S2R, Epidémiologie et Evaluation Cliniques, INSERM, CIC-EC1433, Nancy, France; University de Lorraine, CHU Nancy, Department of Nephrology, Nancy, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Ayav
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057966:Calcimimetic Agents / Q000627:therapeutic use*; D000069449:Cinacalcet / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D057966:Calcimimetic Agents; D010281:Parathyroid Hormone; D000069449:Cinacalcet