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Relationship between reductions in parathyroid hormone and serum phosphorus during the management of secondary hyperparathyroidism with calcimimetics in hemodialysis patients.
Nephron Clin Pract. 2012; 121(3-4):c124-30.NC

Abstract

BACKGROUND/AIM

The relationship between changes in plasma parathyroid hormone (PTH) and serum phosphorus levels during treatment with cinacalcet was evaluated in hemodialysis patients with secondary hyperparathyroidism (SHPT) receiving stable doses of vitamin D.

METHODS

Post hoc analysis of the relationship between PTH and phosphorus levels before and during treatment with cinacalcet in adult subjects on hemodialysis with inadequately controlled SHPT (PTH ≥300 pg/ml) included: (1) correlation of absolute changes from baseline in mean PTH and phosphorus at week 2 and during weeks 13-26; (2) phosphorus levels at baseline and absolute and percent change of phosphorus after cinacalcet administration stratified by baseline PTH level; (3) two regression analyses models were fitted that (a) adjusted for baseline lab values to quantify the relationship between changes in PTH and changes in phosphorus and (b) a multivariate regression analysis that adjusted for clinically relevant subject characteristics.

RESULTS

Serum phosphorus concentrations at baseline were incrementally greater by PTH stratum from lowest to highest. Reductions in PTH from baseline after 13-26 weeks of treatment with cinacalcet were associated with corresponding reductions in serum phosphorus. Two weeks after starting treatment with cinacalcet when doses of vitamin D analogues, phosphate binders, and cinacalcet remained unchanged, there was a statistically significant association (p < 0.0001) between the decreases from baseline in PTH and phosphorus.

CONCLUSIONS

Reductions in PTH during cinacalcet therapy are associated with decreases in serum phosphorus that cannot be explained by changes in vitamin D or phosphate binder therapy, and may reflect diminished phosphorus release from bone.

Authors+Show Affiliations

Amgen Inc., Thousand Oaks, CA 91320-1799, USA. kcooper@amgen.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23208191

Citation

Cooper, Kerry, et al. "Relationship Between Reductions in Parathyroid Hormone and Serum Phosphorus During the Management of Secondary Hyperparathyroidism With Calcimimetics in Hemodialysis Patients." Nephron. Clinical Practice, vol. 121, no. 3-4, 2012, pp. c124-30.
Cooper K, Quarles D, Kubo Y, et al. Relationship between reductions in parathyroid hormone and serum phosphorus during the management of secondary hyperparathyroidism with calcimimetics in hemodialysis patients. Nephron Clin Pract. 2012;121(3-4):c124-30.
Cooper, K., Quarles, D., Kubo, Y., Tomlin, H., & Goodman, W. (2012). Relationship between reductions in parathyroid hormone and serum phosphorus during the management of secondary hyperparathyroidism with calcimimetics in hemodialysis patients. Nephron. Clinical Practice, 121(3-4), c124-30. https://doi.org/10.1159/000345164
Cooper K, et al. Relationship Between Reductions in Parathyroid Hormone and Serum Phosphorus During the Management of Secondary Hyperparathyroidism With Calcimimetics in Hemodialysis Patients. Nephron Clin Pract. 2012;121(3-4):c124-30. PubMed PMID: 23208191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between reductions in parathyroid hormone and serum phosphorus during the management of secondary hyperparathyroidism with calcimimetics in hemodialysis patients. AU - Cooper,Kerry, AU - Quarles,Darryl, AU - Kubo,Yumi, AU - Tomlin,Holly, AU - Goodman,William, Y1 - 2012/11/29/ PY - 2012/07/11/received PY - 2012/10/15/accepted PY - 2012/12/5/entrez PY - 2012/12/5/pubmed PY - 2013/9/5/medline SP - c124 EP - 30 JF - Nephron. Clinical practice JO - Nephron Clin Pract VL - 121 IS - 3-4 N2 - BACKGROUND/AIM: The relationship between changes in plasma parathyroid hormone (PTH) and serum phosphorus levels during treatment with cinacalcet was evaluated in hemodialysis patients with secondary hyperparathyroidism (SHPT) receiving stable doses of vitamin D. METHODS: Post hoc analysis of the relationship between PTH and phosphorus levels before and during treatment with cinacalcet in adult subjects on hemodialysis with inadequately controlled SHPT (PTH ≥300 pg/ml) included: (1) correlation of absolute changes from baseline in mean PTH and phosphorus at week 2 and during weeks 13-26; (2) phosphorus levels at baseline and absolute and percent change of phosphorus after cinacalcet administration stratified by baseline PTH level; (3) two regression analyses models were fitted that (a) adjusted for baseline lab values to quantify the relationship between changes in PTH and changes in phosphorus and (b) a multivariate regression analysis that adjusted for clinically relevant subject characteristics. RESULTS: Serum phosphorus concentrations at baseline were incrementally greater by PTH stratum from lowest to highest. Reductions in PTH from baseline after 13-26 weeks of treatment with cinacalcet were associated with corresponding reductions in serum phosphorus. Two weeks after starting treatment with cinacalcet when doses of vitamin D analogues, phosphate binders, and cinacalcet remained unchanged, there was a statistically significant association (p < 0.0001) between the decreases from baseline in PTH and phosphorus. CONCLUSIONS: Reductions in PTH during cinacalcet therapy are associated with decreases in serum phosphorus that cannot be explained by changes in vitamin D or phosphate binder therapy, and may reflect diminished phosphorus release from bone. SN - 1660-2110 UR - https://wwww.unboundmedicine.com/medline/citation/23208191/Relationship_between_reductions_in_parathyroid_hormone_and_serum_phosphorus_during_the_management_of_secondary_hyperparathyroidism_with_calcimimetics_in_hemodialysis_patients_ L2 - https://www.karger.com?DOI=10.1159/000345164 DB - PRIME DP - Unbound Medicine ER -