Cargando…

Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis

BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of...

Descripción completa

Detalles Bibliográficos
Autores principales: Pérez-Ricart, Ariadna, Galicia-Basart, Maria, Alcalde-Rodrigo, Maria, Segarra-Medrano, Alfons, Suñé-Negre, Josep-Maria, Montoro-Ronsano, José-Bruno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010289/
https://www.ncbi.nlm.nih.gov/pubmed/27588942
http://dx.doi.org/10.1371/journal.pone.0161527
_version_ 1782451661666516992
author Pérez-Ricart, Ariadna
Galicia-Basart, Maria
Alcalde-Rodrigo, Maria
Segarra-Medrano, Alfons
Suñé-Negre, Josep-Maria
Montoro-Ronsano, José-Bruno
author_facet Pérez-Ricart, Ariadna
Galicia-Basart, Maria
Alcalde-Rodrigo, Maria
Segarra-Medrano, Alfons
Suñé-Negre, Josep-Maria
Montoro-Ronsano, José-Bruno
author_sort Pérez-Ricart, Ariadna
collection PubMed
description BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted. Patients were included if they had collected cinacalcet, under off-label use, during 2010 and 2011. Patients selected were followed from the beginning of cinacalcet therapy for one year of treatment. RESULTS: A total of 37 patients were included with CKD stage 3 (38%), 4 (51%) and 5 (11%). Baseline mean PTH value was 400.86 ± 168.60 mg/dl. At 12 months, a 67% of patients achieved at least a 30% reduction in their PTH value (p<0.001; CI 49.7–83.6), and the overall mean reduction of PTH values was 38% (p< 0.001; IC -49.1, -27.5). A 28% of the patients achieved KDOQI PTH goals (p = 0.003, CI 12%-50%). At 12 months, mean serum calcium values decreased by 6% and mean serum phosphorus values increased by 13%. A 19% of patients experienced hypocalcemia episodes while an increase of 24% in hyperphosphatemia episodes was observed. A 25% of patients finished cinacalcet before a year of treatment. Main withdrawal reasons were: gastrointestinal and other discomfort (8%), hypocalcaemia (8%), non-compliance (3%), interactions (3%) and excess of efficacy (3%). CONCLUSIONS: Cinacalcet was effective in patients with CKD and SHPT not receiving dialysis. Electrolytic imbalances could be managed with administration of vitamin D and analogues or phosphate binders.
format Online
Article
Text
id pubmed-5010289
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-50102892016-09-27 Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis Pérez-Ricart, Ariadna Galicia-Basart, Maria Alcalde-Rodrigo, Maria Segarra-Medrano, Alfons Suñé-Negre, Josep-Maria Montoro-Ronsano, José-Bruno PLoS One Research Article BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted. Patients were included if they had collected cinacalcet, under off-label use, during 2010 and 2011. Patients selected were followed from the beginning of cinacalcet therapy for one year of treatment. RESULTS: A total of 37 patients were included with CKD stage 3 (38%), 4 (51%) and 5 (11%). Baseline mean PTH value was 400.86 ± 168.60 mg/dl. At 12 months, a 67% of patients achieved at least a 30% reduction in their PTH value (p<0.001; CI 49.7–83.6), and the overall mean reduction of PTH values was 38% (p< 0.001; IC -49.1, -27.5). A 28% of the patients achieved KDOQI PTH goals (p = 0.003, CI 12%-50%). At 12 months, mean serum calcium values decreased by 6% and mean serum phosphorus values increased by 13%. A 19% of patients experienced hypocalcemia episodes while an increase of 24% in hyperphosphatemia episodes was observed. A 25% of patients finished cinacalcet before a year of treatment. Main withdrawal reasons were: gastrointestinal and other discomfort (8%), hypocalcaemia (8%), non-compliance (3%), interactions (3%) and excess of efficacy (3%). CONCLUSIONS: Cinacalcet was effective in patients with CKD and SHPT not receiving dialysis. Electrolytic imbalances could be managed with administration of vitamin D and analogues or phosphate binders. Public Library of Science 2016-09-02 /pmc/articles/PMC5010289/ /pubmed/27588942 http://dx.doi.org/10.1371/journal.pone.0161527 Text en © 2016 Pérez-Ricart et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Pérez-Ricart, Ariadna
Galicia-Basart, Maria
Alcalde-Rodrigo, Maria
Segarra-Medrano, Alfons
Suñé-Negre, Josep-Maria
Montoro-Ronsano, José-Bruno
Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title_full Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title_fullStr Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title_full_unstemmed Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title_short Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis
title_sort effectiveness of cinacalcet in patients with chronic kidney disease and secondary hyperparathyroidism not receiving dialysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010289/
https://www.ncbi.nlm.nih.gov/pubmed/27588942
http://dx.doi.org/10.1371/journal.pone.0161527
work_keys_str_mv AT perezricartariadna effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis
AT galiciabasartmaria effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis
AT alcalderodrigomaria effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis
AT segarramedranoalfons effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis
AT sunenegrejosepmaria effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis
AT montororonsanojosebruno effectivenessofcinacalcetinpatientswithchronickidneydiseaseandsecondaryhyperparathyroidismnotreceivingdialysis