Role of cinacalcet in the treatment of secondary hyperparathyroidism in chronic kidney disease

Abstract

Introduction — Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease (CKD) affecting most of the patients in end stage renal disease. Materials and Methods — This prospective case control study was conducted on 50 adult patients of CKD, having individual parathyroid hormone (iPTH) levels >300 pg/ml. These patients were divided into two groups: Group I (n=25) received calcitriol in dosage of 0.5 µg/day. Group II (n=25) received cinacalcet in dosage of 30 mg/day and calcitriol 0.5 µg/day. The study was carried out for 6 month duration. Results — The mean basal value of iPTH decreased to 246.40±219.99 pg/ml at the end of the study from basal value of 482.80±229.86 in group II. There was a 43% decrease in serum iPTH values in group II as opposed to the 14% decrease in group I (P<0.05). Serum Ca×P decreased by 9% in group I and by 13% in group II and there was statistically significant difference at the end of 3rd month as well as at the end of study in cinacalcet group. Conclusion — Cinacalcet is unique in its ability to simultaneously lower PTH, calcium, phosphorus and Ca×P in patients with SHPT and thus could become an important component in treatment of CKD patients.

Keywords

• secondary hyperparathyroidism
• chronic kidney disease
• cinacalcet
• parathyroid hormone
• serum calcium
• serum phosphorus