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2000
Volume 31, Issue 16
  • ISSN: 1381-6128
  • E-ISSN: 1873-4286

Abstract

Introduction

Chronic Kidney Disease (CKD) is recognized as a major global public health problem. Dialysis is the mainstay of treatment for patients with end-stage renal disease and can prolong survival in patients with CKD. As patient survival increases, the treatment of complications becomes more important. CKD-mineral and bone disorders (CKD-MBD) and renal anemia are common complications in patients with CKD. Cinacalcet is a calcimimetic for the treatment of secondary hyperparathyroidism (SHPT) in adult dialysis patients, which regulates the synthesis and secretion of parathyroid hormone by increasing the sensitivity of calcium-sensitive receptors. This retrospective study evaluated the efficacy of cinacalcet in dialysis patients.

Methods

Forty-six patients on dialysis with elevated parathyroid hormone were included. The selected patients have regular follow-up visits in our outpatient clinic and regular use of cinacalcet for no less than 6 months.

Results

During the 6-month efficacy evaluation phase, cinacalcet not only reduced the levels of the intact parathyroid hormone (iPTH, 0.05), serum calcium ( 0.01), and Ca×P ( 0.05) but also reduced weekly erythropoietin (EPO) dosage ( 0.01) and erythropoietin resistance index (ERI, 0.05).

Conclusion

While controlling SHPT in patients with CKD, cinacalcet reduced EPO resistance and improved renal anemia. In conclusion, cinacalcet not only decreased the levels of the iPTH, serum calcium, and Ca×P but also reduced weekly EPO dosage and ERI levels. Controlling SHPT in patients with CKD, cinacalcet also reduced ERI and improved renal anemia.

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2025-01-14
2025-05-20
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References

  1. Ene-IordacheB. PericoN. BikbovB. CarminatiS. RemuzziA. PernaA. IslamN. BravoR.F. Aleckovic-HalilovicM. ZouH. ZhangL. GoudaZ. TchokhonelidzeI. AbrahamG. Mahdavi-MazdehM. GallieniM. CodreanuI. TogtokhA. SharmaS.K. KoiralaP. UpretyS. UlasiI. RemuzziG. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): A cross-sectional study.Lancet Glob. Health201645e307e31910.1016/S2214‑109X(16)00071‑127102194
    [Google Scholar]
  2. HillN.R. FatobaS.T. OkeJ.L. HirstJ.A. O’CallaghanC.A. LassersonD.S. HobbsF.D.R. Global prevalence of chronic kidney disease – A systematic review and meta-analysis.PLoS One2016117e015876510.1371/journal.pone.015876527383068
    [Google Scholar]
  3. WangL. XuX. ZhangM. HuC. ZhangX. LiC. NieS. HuangZ. ZhaoZ. HouF.F. ZhouM. Prevalence of chronic kidney disease in China.JAMA Intern. Med.2023183429831010.1001/jamainternmed.2022.681736804760
    [Google Scholar]
  4. CunninghamJ. LocatelliF. RodriguezM. Secondary hyperparathyroidism.Clin. J. Am. Soc. Nephrol.20116491392110.2215/CJN.0604071021454719
    [Google Scholar]
  5. TanakaM. KomabaH. FukagawaM. Emerging association between parathyroid hormone and anemia in hemodialysis patients.Ther. Apher. Dial.201822324224510.1111/1744‑9987.1268529767854
    [Google Scholar]
  6. Barman BalfourJ.A. ScottL.J. Cinacalcet Hydrochloride.Drugs200565227128110.2165/00003495‑200565020‑0000715631545
    [Google Scholar]
  7. AdamsG.B. ChabnerK.T. AlleyI.R. OlsonD.P. SzczepiorkowskiZ.M. PoznanskyM.C. KosC.H. PollakM.R. BrownE.M. ScaddenD.T. Stem cell engraftment at the endosteal niche is specified by the calcium-sensing receptor.Nature2006439707659960310.1038/nature0424716382241
    [Google Scholar]
  8. DrüekeT.B. Haematopoietic stem cells-role of calcium-sensing receptor in bone marrow homing.Nephrol. Dial. Transplant.20062182072207416702207
    [Google Scholar]
  9. MoeS.M. ChertowG.M. ParfreyP.S. KuboY. BlockG.A. Correa-RotterR. DrüekeT.B. HerzogC.A. LondonG.M. MahaffeyK.W. WheelerD.C. StolinaM. DehmelB. GoodmanW.G. FloegeJ. Cinacalcet, fibroblast growth factor-23, and cardiovascular disease in hemodialysis.Circulation20151321273910.1161/CIRCULATIONAHA.114.01387626059012
    [Google Scholar]
  10. CoeL.M. MadathilS.V. CasuC. LanskeB. RivellaS. SitaraD. FGF-23 is a negative regulator of prenatal and postnatal erythropoiesis.J. Biol. Chem.2014289149795981010.1074/jbc.M113.52715024509850
    [Google Scholar]
  11. DrüekeT.B. ParfreyP.S. Summary of the KDIGO guideline on anemia and comment: Reading between the (guide)line(s).Kidney Int.201282995296010.1038/ki.2012.27022854645
    [Google Scholar]
  12. López-GómezJ.M. PortolésJ.M. AljamaP. Factors that condition the response to erythropoietin in patients on hemodialysis and their relation to mortality.Kidney Int.200874111S75S8110.1038/ki.2008.52319034333
    [Google Scholar]
  13. YangC. YangZ. WangJ. WangH.Y. SuZ. ChenR. SunX. GaoB. WangF. ZhangL. JiangB. ZhaoM.H. Estimation of prevalence of kidney disease treated with dialysis in china: A study of insurance claims data.Am. J. Kidney Dis.2021776889897.e110.1053/j.ajkd.2020.11.02133421457
    [Google Scholar]
  14. KDIGO 2017 Clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD-MBD).Kidney Int. Suppl.20177115910.1016/j.kisu.2017.04.001
    [Google Scholar]
  15. HuL. NapoletanoA. ProvenzanoM. GarofaloC. BiniC. ComaiG. La MannaG. Mineral bone disorders in kidney disease patients: The ever-current topic.Int. J. Mol. Sci.202223201222310.3390/ijms23201222336293076
    [Google Scholar]
  16. SpragueS.M. MartinK.J. CoyneD.W. Phosphate balance and CKD–mineral bone disease.Kidney Int. Rep.2021682049205810.1016/j.ekir.2021.05.01234386654
    [Google Scholar]
  17. BellasiA. MandreoliM. BaldratiL. CorradiniM. Di NicolòP. MalmusiG. SantoroA. Chronic kidney disease progression and outcome according to serum phosphorus in mild-to-moderate kidney dysfunction.Clin. J. Am. Soc. Nephrol.20116488389110.2215/CJN.0781091021393493
    [Google Scholar]
  18. GengS. KuangZ. PeissigP.L. Parathyroid hormone independently predicts fracture, vascular events, and death in patients with stage 3 and 4 chronic kidney disease.Osteoporosis international: A journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019301020192025
    [Google Scholar]
  19. BrownE.M. Role of the calcium-sensing receptor in extracellular calcium homeostasis.Best Pract. Res. Clin. Endocrinol. Metab.201327333334310.1016/j.beem.2013.02.00623856263
    [Google Scholar]
  20. UreñaP. LegoupilN. De VernejoulM.C. Calcimimetics, mechanisms of action and therapeutic applications.Presse Med.200534151100
    [Google Scholar]
  21. LindbergJ.S. MoeS.M. GoodmanW.G. CoburnJ.W. SpragueS.M. LiuW. BlaisdellP.W. BrennerR.M. TurnerS.A. MartinK.J. The calcimimetic AMG 073 reduces parathyroid hormone and calcium x phosphorus in secondary hyperparathyroidism.Kidney Int.200363124825410.1046/j.1523‑1755.2003.00720.x12472790
    [Google Scholar]
  22. WheelerD.C. LondonG.M. ParfreyP.S. BlockG.A. Correa-RotterR. DehmelB. DrüekeT.B. FloegeJ. KuboY. MahaffeyK.W. GoodmanW.G. MoeS.M. TrotmanM.L. AbdallaS. ChertowG.M. HerzogC.A. Effects of cinacalcet on atherosclerotic and nonatherosclerotic cardiovascular events in patients receiving hemodialysis: The evaluation of cinacalcet HCl therapy to lower cardiovascular events (EVOLVE) trial.J. Am. Heart Assoc.201436e00136310.1161/JAHA.114.00136325404192
    [Google Scholar]
  23. WangA.Y.M. TangT.K. YauY.Y. LoW.K. Impact of parathyroidectomy versus oral cinacalcet on bone mineral density in patients on peritoneal dialysis with advanced secondary Hyperparathyroidism: The PROCEED pilot randomized trial.Am. J. Kidney Dis.2024834456466.e110.1053/j.ajkd.2023.10.00738040277
    [Google Scholar]
  24. TsaiS.H. KanW.C. JhenR.N. ChangY.M. KaoJ.L. LaiH.Y. LiouH.H. ShiaoC.C. Secondary hyperparathyroidism in chronic kidney disease: A narrative review focus on therapeutic strategy.Clin. Med. (Lond.)202424510023810.1016/j.clinme.2024.10023839208984
    [Google Scholar]
  25. FligorS.C. LiC. HamaguchiR. WilliamJ. JamesB.C. Decreasing surgical management of secondary hyperparathyroidism in the United States.J. Surg. Res.202126444445310.1016/j.jss.2021.03.01333848844
    [Google Scholar]
  26. SunY. TianB. ShengZ. WanP. XuT. YaoL. Efficacy and safety of cinacalcet compared with other treatments for secondary hyperparathyroidism in patients with chronic kidney disease or end-stage renal disease: a meta-analysis.BMC Nephrol.202021131610.1186/s12882‑019‑1639‑932736534
    [Google Scholar]
  27. RaoD.S. ShihM. MohiniR. Effect of serum parathyroid hormone and bone marrow fibrosis on the response to erythropoietin in uremia.N. Engl. J. Med.1993328317117510.1056/NEJM1993012132803048417383
    [Google Scholar]
  28. UreñaP. EckardtK.U. SarfatiE. ZingraffJ. ZinsB. RoulletJ.B. RolandE. DrüekeT. KurtzA. Serum erythropoietin and erythropoiesis in primary and secondary hyperparathyroidism: Effect of parathyroidectomy.Nephron J.199159338439310.1159/0001865961758526
    [Google Scholar]
  29. MeytesD. BoginE. MaA. DukesP.P. MassryS.G. Effect of parathyroid hormone on erythropoiesis.J. Clin. Invest.19816751263126910.1172/JCI1101547229028
    [Google Scholar]
  30. BoginE. MassryS.G. LeviJ. DjaldetiM. BristolG. SmithJ. Effect of parathyroid hormone on osmotic fragility of human erythrocytes.J. Clin. Invest.19826941017102510.1172/JCI1105056281309
    [Google Scholar]
  31. AkmalM. TelferN. AnsariA.N. MassryS.G. Erythrocyte survival in chronic renal failure. Role of secondary hyperparathyroidism.J. Clin. Invest.19857641695169810.1172/JCI1121574056047
    [Google Scholar]
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