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Cinacalcet de novo in persistent hypercalcemia after kidney transplantation secondary to hyperparathyroidism: long-term follow-up and effect of withdrawal.
Transplant Proc. 2012 Oct; 44(8):2376-8.TP

Abstract

BACKGROUND

Secondary hyperparathyroidism that persists after kidney transplantation (KT), is the main cause of hypercalcemia. Cinacalcet has been used to control hypercalcemia in KT patients.

OBJECTIVE

The aim of this study was to evaluate the effect of de novo cinacalcet in KT patients with hypercalcemia and the evolution after its withdrawal.

METHODS

This observational study included 41 KT patients (17 men) with persistent hypercalcemia (>6 months), defined as serum calcium (sCa) ≥10.5 mg/dL, and a mean age of 51.1 ± 13.3 years with a functional allograft for >12 months. The time after surgery to begin cinacalcet was 33 months (range, 12.5-81.3). The initial dose of cinacalcet was 30 mg/d. In a subgroup of 14 patients cinacalcet was stopped after 1 year. We studied the evolution of serum levels of calcium, phosphorus, intact pathyroid hormone (iPTH), and serum creatinine.

RESULTS

Calcemia normalized in all patients (sCa <10.2 mg/dL). iPTH decreased (basal 267 ± 212 pg/mL vs final: 219 ± 160 pg/mL; P = ns) Serum phosphorus increased (basal 2.85 ± 0.48 mg/dL vs final 3.16 ± 0.50 mg/dL; P = ns). Renal function remained stable (basal creatinine 1.49 ± 0.48 vs final 1.47 ± 0.32 mg/dL; P = ns). After stopping cinacalcet, in group 1 calcemia persisted at normal levels in 50% (n = 7), but the drug had to be reintroduced in the other 50% after 10 ± 7.9 months. No adverse events were documented.

CONCLUSIONS

Cinacalcet is an effective alternative for the treatment of hypercalcemia in patients with persistent hyperparathyroidism after KT. Once the treatment is started, there is presently no invice to disclose to who tolerate its withdrawal or the time to do so.

Authors+Show Affiliations

Nephrology and Renal Transplant Department, Hospital Clinic Barcelona, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23026597

Citation

Paschoalin, R P., et al. "Cinacalcet De Novo in Persistent Hypercalcemia After Kidney Transplantation Secondary to Hyperparathyroidism: Long-term Follow-up and Effect of Withdrawal." Transplantation Proceedings, vol. 44, no. 8, 2012, pp. 2376-8.
Paschoalin RP, Torregrosa JV, Barros X, et al. Cinacalcet de novo in persistent hypercalcemia after kidney transplantation secondary to hyperparathyroidism: long-term follow-up and effect of withdrawal. Transplant Proc. 2012;44(8):2376-8.
Paschoalin, R. P., Torregrosa, J. V., Barros, X., Durán, C. E., & Campistol, J. M. (2012). Cinacalcet de novo in persistent hypercalcemia after kidney transplantation secondary to hyperparathyroidism: long-term follow-up and effect of withdrawal. Transplantation Proceedings, 44(8), 2376-8. https://doi.org/10.1016/j.transproceed.2012.07.049
Paschoalin RP, et al. Cinacalcet De Novo in Persistent Hypercalcemia After Kidney Transplantation Secondary to Hyperparathyroidism: Long-term Follow-up and Effect of Withdrawal. Transplant Proc. 2012;44(8):2376-8. PubMed PMID: 23026597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cinacalcet de novo in persistent hypercalcemia after kidney transplantation secondary to hyperparathyroidism: long-term follow-up and effect of withdrawal. AU - Paschoalin,R P, AU - Torregrosa,J V, AU - Barros,X, AU - Durán,C E, AU - Campistol,J M, PY - 2012/10/3/entrez PY - 2012/10/3/pubmed PY - 2013/3/13/medline SP - 2376 EP - 8 JF - Transplantation proceedings JO - Transplant Proc VL - 44 IS - 8 N2 - BACKGROUND: Secondary hyperparathyroidism that persists after kidney transplantation (KT), is the main cause of hypercalcemia. Cinacalcet has been used to control hypercalcemia in KT patients. OBJECTIVE: The aim of this study was to evaluate the effect of de novo cinacalcet in KT patients with hypercalcemia and the evolution after its withdrawal. METHODS: This observational study included 41 KT patients (17 men) with persistent hypercalcemia (>6 months), defined as serum calcium (sCa) ≥10.5 mg/dL, and a mean age of 51.1 ± 13.3 years with a functional allograft for >12 months. The time after surgery to begin cinacalcet was 33 months (range, 12.5-81.3). The initial dose of cinacalcet was 30 mg/d. In a subgroup of 14 patients cinacalcet was stopped after 1 year. We studied the evolution of serum levels of calcium, phosphorus, intact pathyroid hormone (iPTH), and serum creatinine. RESULTS: Calcemia normalized in all patients (sCa <10.2 mg/dL). iPTH decreased (basal 267 ± 212 pg/mL vs final: 219 ± 160 pg/mL; P = ns) Serum phosphorus increased (basal 2.85 ± 0.48 mg/dL vs final 3.16 ± 0.50 mg/dL; P = ns). Renal function remained stable (basal creatinine 1.49 ± 0.48 vs final 1.47 ± 0.32 mg/dL; P = ns). After stopping cinacalcet, in group 1 calcemia persisted at normal levels in 50% (n = 7), but the drug had to be reintroduced in the other 50% after 10 ± 7.9 months. No adverse events were documented. CONCLUSIONS: Cinacalcet is an effective alternative for the treatment of hypercalcemia in patients with persistent hyperparathyroidism after KT. Once the treatment is started, there is presently no invice to disclose to who tolerate its withdrawal or the time to do so. SN - 1873-2623 UR - https://wwww.unboundmedicine.com/medline/citation/23026597/Cinacalcet_de_novo_in_persistent_hypercalcemia_after_kidney_transplantation_secondary_to_hyperparathyroidism:_long_term_follow_up_and_effect_of_withdrawal_ DB - PRIME DP - Unbound Medicine ER -