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Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism.
Ther Apher Dial. 2015 Aug; 19(4):367-77.TA

Abstract

The long-term effect of cinacalcet hydrochloride treatment on parathyroid gland (PTG) volume has been scarcely investigated in patients with moderate to advanced secondary hyperparathyroidism (SHPT). The present study was a prospective observational study to determine the effect of cinacalcet treatment on PTG volume and serum biochemical parameters in 60 patients with renal SHPT, already treated with intravenous vitamin D receptor activator (VDRA). Measurement of biochemical parameters and PTG volumes were performed periodically, which were analyzed by stratification into tertiles across the baseline parathyroid hormone (PTH) level or PTG volume. We also determined the factors that can estimate the changes in PTG volume and the achievement of the target PTH range by multivariable analyses. Two years of cinacalcet treatment significantly decreased the serum levels of PTH, calcium, and phosphate, followed by the improvement of achieving the target ranges for these parameters recommended by the Japanese Society for Dialysis Therapy. Cinacalcet decreased the maximal and total PTG volume by about 30%, and also decreased the serum PTH level independent of the baseline serum PTH level and PTG volume. Ten out of 60 patients showed 30% increase in maximal PTG after 2 years. Multivariable analysis showed that patients with nodular PTG at baseline and patients with higher serum calcium and PTH levels at 1 year were likely to exceed the target range of PTH at two years. In conclusion, cinacalcet treatment with intravenous VDRA therapy decreased both PTG volume and serum intact PTH level, irrespective of the pretreatment PTG status and past treatment history.

Authors+Show Affiliations

Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan. Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan. Fukuoka Renal Clinic, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan. Fukuoka Renal Clinic, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan. Fukuoka Renal Clinic, Fukuoka, Japan.Fukuoka Renal Clinic, Fukuoka, Japan.Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan.Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan. Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

25851690

Citation

Yamada, Shunsuke, et al. "Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism." Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, vol. 19, no. 4, 2015, pp. 367-77.
Yamada S, Tokumoto M, Taniguchi M, et al. Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism. Ther Apher Dial. 2015;19(4):367-77.
Yamada, S., Tokumoto, M., Taniguchi, M., Toyonaga, J., Suehiro, T., Eriguchi, R., Fujimi, S., Ooboshi, H., Kitazono, T., & Tsuruya, K. (2015). Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism. Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 19(4), 367-77. https://doi.org/10.1111/1744-9987.12292
Yamada S, et al. Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism. Ther Apher Dial. 2015;19(4):367-77. PubMed PMID: 25851690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two Years of Cinacalcet Hydrochloride Treatment Decreased Parathyroid Gland Volume and Serum Parathyroid Hormone Level in Hemodialysis Patients With Advanced Secondary Hyperparathyroidism. AU - Yamada,Shunsuke, AU - Tokumoto,Masanori, AU - Taniguchi,Masatomo, AU - Toyonaga,Jiro, AU - Suehiro,Takaichi, AU - Eriguchi,Rieko, AU - Fujimi,Satoru, AU - Ooboshi,Hiroaki, AU - Kitazono,Takanari, AU - Tsuruya,Kazuhiko, Y1 - 2015/04/07/ PY - 2015/4/9/entrez PY - 2015/4/9/pubmed PY - 2016/6/23/medline KW - Cinacalcet KW - Hemodialysis KW - Parathyroid gland KW - Parathyroid hormone KW - Secondary hyperparathyroidism SP - 367 EP - 77 JF - Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy JO - Ther Apher Dial VL - 19 IS - 4 N2 - The long-term effect of cinacalcet hydrochloride treatment on parathyroid gland (PTG) volume has been scarcely investigated in patients with moderate to advanced secondary hyperparathyroidism (SHPT). The present study was a prospective observational study to determine the effect of cinacalcet treatment on PTG volume and serum biochemical parameters in 60 patients with renal SHPT, already treated with intravenous vitamin D receptor activator (VDRA). Measurement of biochemical parameters and PTG volumes were performed periodically, which were analyzed by stratification into tertiles across the baseline parathyroid hormone (PTH) level or PTG volume. We also determined the factors that can estimate the changes in PTG volume and the achievement of the target PTH range by multivariable analyses. Two years of cinacalcet treatment significantly decreased the serum levels of PTH, calcium, and phosphate, followed by the improvement of achieving the target ranges for these parameters recommended by the Japanese Society for Dialysis Therapy. Cinacalcet decreased the maximal and total PTG volume by about 30%, and also decreased the serum PTH level independent of the baseline serum PTH level and PTG volume. Ten out of 60 patients showed 30% increase in maximal PTG after 2 years. Multivariable analysis showed that patients with nodular PTG at baseline and patients with higher serum calcium and PTH levels at 1 year were likely to exceed the target range of PTH at two years. In conclusion, cinacalcet treatment with intravenous VDRA therapy decreased both PTG volume and serum intact PTH level, irrespective of the pretreatment PTG status and past treatment history. SN - 1744-9987 UR - https://wwww.unboundmedicine.com/medline/citation/25851690/Two_Years_of_Cinacalcet_Hydrochloride_Treatment_Decreased_Parathyroid_Gland_Volume_and_Serum_Parathyroid_Hormone_Level_in_Hemodialysis_Patients_With_Advanced_Secondary_Hyperparathyroidism_ DB - PRIME DP - Unbound Medicine ER -