title: The effects of cinacalcet treatment on bone mineral metabolism, anemia parameters, left ventricular mass index and parathyroid gland volume in hemodialysis patients with severe secondary hyperparathyroidism.
abstract: The aim of this study was to investigate the effects of cinacalcet therapy on anemia parameters, bone mineral metabolism, left ventricular mass index (LVMI) and parathyroid gland volume in hemodialysis (HD) patients with secondary hyperparathyroidism. Twenty-five HD patients (M/F: 11/14, mean age: 45.2±17.9 years, mean HD duration: 96.4±32.7 months) were included in this prospective pilot study. The indication to start calcimimetic therapy was persistent serum levels of parathyroid hormone (PTH)>1000 pg/mL, refractory to intravenous (i.v.) vitamin D and phosphate-binding therapy. The initial and one-year results of adjusted serum calcium (Ca+2), phosphate (P), Ca×P product, PTH, hemoglobin (Hb) and ferritin levels, transferrin saturation index (TSAT), median weekly erythropoietin (EPO) dose, LVMI, and parathyroid volume by parathyroid ultrasonography were determined. There were no differences between pre- and post-treatment levels of serum Ca+2 (P=0.853), P (P=0.447), Ca×P product (P=0.587), PTH (P=0.273), ferritin (P=0.153) and TSAT (P=0.104). After 1 year of calcimimetic therapy, the Hb levels were significantly higher than the initial levels (P=0.048). The weekly dose of EPO decreased with no statistical significance. The dose of cinacalcet was increased from 32.4±12.0 to 60.0±24.4 mg/day (P=0.01). There were no differences between the pre- and post-treatment results regarding weekly vitamin D dose, parenteral iron dose, LVMI and parathyroid volume. The results of our study suggest that cinacalcet therapy might have an additional benefit in the control anemia in HD patients.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Baskent University, Adana Teaching and Research Center, Adana, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Torun
authors.forename: Ismail
authors.initials: I
authors.lastname: Yildiz
authors.forename: Hasan
authors.initials: H
authors.lastname: Micozkadioglu
authors.forename: Gul Nihal
authors.initials: GN
authors.lastname: Nursal
authors.forename: Fatma
authors.initials: F
authors.lastname: Yigit
authors.forename: Ruya
authors.initials: R
authors.lastname: Ozelsancak
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects*; D057966:Calcimimetic Agents / Q000627:therapeutic use; D002118:Calcium / Q000378:metabolism; D000069449:Cinacalcet / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D057966:Calcimimetic Agents; D002118:Calcium; D000069449:Cinacalcet