title: Treatment with cinacalcet increases plasma sclerostin concentration in hemodialysis patients with secondary hyperparathyroidism.
abstract: Sclerostin is a paracrine acting factor, which is expressed in the osteocytes and articular chondrocytes. Sclerostin decreases the osteoblast-related bone formation through the inhibition of the Wnt/β-catenin pathway. Osteocytes also express the Calcium sensing receptor which is a target for cinacalcet. The aim of this study was to assess the influence of six-month cinacalcet treatment on plasma sclerostin concentration in hemodialysed patients with secondary hyperparathyroidism (sHPT).
  
  
  
  In 58 hemodialysed patients with sHPT (PTH > 300 pg/ml) plasma sclerostin and serum PTH, calcium and phosphate concentrations were assessed before the first dose of cinacalcet and after 3 and 6 months of treatment.
  
  
  
  Serum PTH concentration decreased after 3 and 6 month of treatment from 1138 (931-1345) pg/ml to 772 (551-992) pg/ml and to 635 (430-839) pg/ml, respectively. Mean serum calcium and phosphate concentrations remained stable. Plasma sclerostin concentration increased after 3 and 6 months of treatment from 1.66 (1.35-1.96) ng/ml, to 1.77 (1.43-2.12) ng/ml and to 1.87 (1.50-2.25) ng/ml, respectively. In 42 patients with cinacalcet induced serum PTH decrease plasma sclerostin concentration increased after 3 and 6 months of treatment from 1.51 (1.19-1.84) ng/ml to 1.59 (1.29-1.89) ng/ml and to 1.75 (1.42-2.01) ng/ml, respectively. Contrary, in the 16 patients without cinacalcet induced serum PTH decrease plasma sclerostin concentration was stable. Plasma sclerostin concentrations correlated inversely with serum PTH concentrations at the baseline and also after 6 months of treatment.
  
  
  
  1. In hemodialysed patients with secondary hyperparathyroidism treatment with cinacalcet increases plasma sclerostin concentration 2. This effect seems to be related to decrease of serum PTH concentration.
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24 Str, 40-027, Katowice, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kuczera
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24 Str, 40-027, Katowice, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Adamczak
authors.affiliation: Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24 Str, 40-027, Katowice, Poland. awiecek@sum.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Więcek
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D057966:Calcimimetic Agents / Q000627:therapeutic use*; D000069449:Cinacalcet / Q000627:therapeutic use*; D005260:Female; D005819:Genetic Markers; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000639:trends; D016896:Treatment Outcome
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; D057966:Calcimimetic Agents; D005819:Genetic Markers; C422903:SOST protein, human; D000069449:Cinacalcet
keywords: Cinacalcet; Hemodialysis; Sclerostin; Secondary hyperparathyroidism