title: Use of cinacalcet for the management of hyperparathyroidism in patients with different degrees of renal failure.
abstract: BACKGROUND
  The effects of cinacalcet in persistent and/or hypercalcaemia-associated secondary hyperparathyroidism (SHPT) have been described in patients on dialysis.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of cinacalcet in SHPT not on dialysis and its effects on bone turnover markers.
  
  
  METHODS
  Non-randomised, longitudinal, observational, analytical study of patients with chronic kidney disease (CKD) and SHPT (PTH> 80 pg/mL) as well as normo- or hypercalcaemia (≥8.5mg/dL), treated with cinacalcet.
  
  
  RESULTS
  Mean cinacalcet dose was 30mg/day in 66.7%. We studied 15 patients (10 women), aged 66.0±17.93years. The aetiology was unknown in 20% of cases. Sociodemographic variables and renal function parameters were recorded. We compared values at baseline as well as after 6 and 12 months. Calcium (10.3±0.55 vs. 9.4±1.04) and iPTH (392.4±317.65 vs. 141.8±59.26) levels decreased. Increased levels of phosphorus (3.7±1.06 vs. 3.9±0.85) and ß-CTX (884.2±797.22 vs. 1053.6±999.00) were detected, although there were no significant changes in GFR, urinary calcium or other bone markers. Two patients withdrew from the study (gastrointestinal intolerance and parathyroidectomy, respectively).
  
  
  CONCLUSIONS
  Cinacalcet at low doses is effective in the management of SHPT in CKD patients who are not on dialysis. Its use reduces iPTH and calcaemia, without causing serious side effects or significant changes in renal function.
authors.affiliation: UGC de Nefrología, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España. Electronic address: jmoagreda7@hotmail.com.
authors.forename: José M
authors.initials: JM
authors.lastname: Orellana
authors.affiliation: UGC de Nefrología, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España.
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Esteban
authors.affiliation: UGC de Nefrología, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España.
authors.forename: Yina A
authors.initials: YA
authors.lastname: Castilla
authors.affiliation: Facultad de Ciencias de la Salud, Universidad de Granada, Granada, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fernández-Castillo
authors.affiliation: UGC de Farmacia, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Nozal-Fernández
authors.affiliation: UGC de Churriana, Distrito Sanitario de Granada, Granada, España.
authors.forename: María A
authors.initials: MA
authors.lastname: Esteban
authors.affiliation: UGC de Nefrología, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España.
authors.forename: María
authors.initials: M
authors.lastname: García-Valverde
authors.affiliation: UGC de Nefrología, Hospitales Virgen de las Nieves y Clínico San Cecilio, Granada, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Bravo
mesh_terms: D000328:Adult; D000368:Aged; D057966:Calcimimetic Agents / Q000627:therapeutic use*; D002118:Calcium; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone; D010758:Phosphorus; D006435:Renal Dialysis
chemical_list: D057966:Calcimimetic Agents; D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium; D000069449:Cinacalcet
keywords: Bone turnover markers; Calcio; Calcium; Chronic kidney disease; Cinacalcet; Enfermedad renal crónica; Fósforo; Hiperparatiroidismo secundario; Hormona paratiroidea; Marcadores de recambio óseo; Parathyroid hormone; Phosphorus; Secondary hyperparathyroidism