Evaluation of Cinacalcet HCl Treatment After Kidney Transplantation

• Published in: Transplantation proceedings 2010-09, Vol.42 (7), p.2503-2508
• Main Authors: Copley, J.B, Germain, M, Stern, L, Pankewycz, O, Katznelson, S, Shah, T, Wang, O, Turner, S.A, Sprague, S.M
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Bone and Bones - drug effects; Bone and Bones - metabolism; Cinacalcet Hydrochloride; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glomerular Filtration Rate; Humans; Hypercalcemia - drug therapy; Hyperparathyroidism, Secondary - drug therapy; Kidney Transplantation - adverse effects; Medical sciences; Naphthalenes - therapeutic use; Parathyroid Hormone - blood; Patient Selection; Postoperative Complications - drug therapy; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.04.052

Abstract Background Hyperparathyroidism often remains or develops after kidney transplantation. Vitamin D sterol used as treatment for an elevated parathyroid hormone (PTH) level and associated bone disease may be contraindicated due to hypercalcemia. The calcimimetic cinacalcet HCl (cinacalcet), which lowers PTH and calcium (Ca) in chronic kidney disease patients, may represent an alternate therapeutic modality. Methods This multicenter, retrospective, observational study examined 41 kidney transplant patients receiving cinacalcet for ≥3 months starting ≥3 months posttransplantation. Levels of intact PTH, Ca, and phosphorus (P) were examined during the assessment phase (3–6 months after initiation). Results Median PTH decreased 21.8% during the assessment phase ( P < .001), with 32.5% of patients exhibiting a ≥30% decrease in PTH from baseline. Median Ca decreased 6.8% ( P < .0001). Median serum P rose 10.0% ( P = .0124), but remained within normal limits. The estimated glomerular filtration rate was stable throughout the study. Conclusions Cinacalcet may be useful for the treatment of hyperparathyroidism after kidney transplantation. Randomized, prospectively designed clinical trials are required to confirm these results.