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Administration of calcimimetics after dialysis: same effectiveness, better gastrointestinal tolerability.
Nefrologia. 2015; 35(4):403-9.N

Abstract

INTRODUCTION

Cinacalcet has proved effective to control secondary hyperparathyroidism in patients on haemodialysis (HD). Some studies have reported an appropriate secondary hyperparathyroidism control and a better compliance after intradialytic use of calcimimetics.

OBJECTIVES

To assess the effect of post-dialysis calcimimetics use on mineral bone disorders and calcimimetics gastrointestinal tolerability in our HD unit.

MATERIAL AND METHODS

A 12-week single-centre prospective study in HD patients treated with cinacalcet (>2 months). Two study periods: Usual outpatient use (Stage 1) and use after HD session (Stage 2).

ENDPOINTS

1) Biochemical MBD data; 2) Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal tolerability, and visual analogic scale (VAS) for satisfaction; 3) Adherence: Morisky-Green test (MG) and final tablet count (TC).

RESULTS

Sixty-two HD patients. Fourteen received cinacalcet (22.5%). TEN patients were included, mean age was 60.9 years; patients had received HD for 80.9 months. Mean Charlson index: 9. Biochemical data: Stage 1 (initial vs. final): Ca 8.8 ± 0.5 vs. 9.1 ± 0.7 mg/dl (p<0.05); P 5.2 ± 0.8 vs. 4.5 ± 1.6 mg/dl, iPTH 360.3 ± 232.7 vs. 349 ± 122 pg/ml. MG: 70%. Stage 2 (initial vs. final): Ca 9.1 ± 0.7 vs. 8.8 ± 0.6 mg/dl; P 4.5 ± 1.6 vs. 4.6 ± 1.3 mg/dl, iPTH 360.3 ± 232.7 vs. 349 ± 122 pg/ml. TC: 89%. GSRS and VAS were better in Stage 2 (GSRS 7.5 ± 5.2 vs. 4.3 ± 1.9; VAS 4.8 ± 2.3 vs. 6.9 ± 2.8). No significant changes were observed in calcimimetic dose (201 vs. 207 mg/wk), number of phosphate binders (9 vs. 8.2 pts/day), native vitamin D (70 vs. 60%), selective vit D receptor activators (30%), or suitable dialysis parameters.

CONCLUSIONS

Post-dialysis use of calcimimetic was effective in secondary hyperparathyroidism control, improved gastrointestinal tolerability and ameliorated patients' satisfaction. Based on our findings, post-dialysis use of calcimimetics should be considered in selected patients with low therapeutic compliance.

Authors+Show Affiliations

Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España. Electronic address: vesteve@cst.cat.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Farmacia Hospitalaria, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.Servicio de Nefrología, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.

Pub Type(s)

Journal Article
Observational Study

Language

eng spa

PubMed ID

26306967

Citation

Esteve Simo, Vicent, et al. "Administration of Calcimimetics After Dialysis: Same Effectiveness, Better Gastrointestinal Tolerability." Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia, vol. 35, no. 4, 2015, pp. 403-9.
Esteve Simo V, Moreno-Guzmán F, Martínez Calvo G, et al. Administration of calcimimetics after dialysis: same effectiveness, better gastrointestinal tolerability. Nefrologia. 2015;35(4):403-9.
Esteve Simo, V., Moreno-Guzmán, F., Martínez Calvo, G., Fulquet Nicolas, M., Pou Potau, M., Macias-Toro, J., Duarte-Gallego, V., Saurina Sole, A., & Ramírez-de Arellano Serna, M. (2015). Administration of calcimimetics after dialysis: same effectiveness, better gastrointestinal tolerability. Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia, 35(4), 403-9. https://doi.org/10.1016/j.nefro.2015.06.013
Esteve Simo V, et al. Administration of Calcimimetics After Dialysis: Same Effectiveness, Better Gastrointestinal Tolerability. Nefrologia. 2015;35(4):403-9. PubMed PMID: 26306967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Administration of calcimimetics after dialysis: same effectiveness, better gastrointestinal tolerability. AU - Esteve Simo,Vicent, AU - Moreno-Guzmán,Fátima, AU - Martínez Calvo,Gemma, AU - Fulquet Nicolas,Miquel, AU - Pou Potau,Monica, AU - Macias-Toro,Javier, AU - Duarte-Gallego,Verónica, AU - Saurina Sole,Anna, AU - Ramírez-de Arellano Serna,Manel, Y1 - 2015/07/08/ PY - 2014/12/29/received PY - 2014/12/29/accepted PY - 2015/8/27/entrez PY - 2015/8/27/pubmed PY - 2017/5/10/medline KW - Calcimimetics KW - Calcimiméticos KW - Haemodialysis KW - Hemodiálisis KW - Hiperparatiroidismo secundario KW - Secondary hyperparathyroidism SP - 403 EP - 9 JF - Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia JO - Nefrologia VL - 35 IS - 4 N2 - INTRODUCTION: Cinacalcet has proved effective to control secondary hyperparathyroidism in patients on haemodialysis (HD). Some studies have reported an appropriate secondary hyperparathyroidism control and a better compliance after intradialytic use of calcimimetics. OBJECTIVES: To assess the effect of post-dialysis calcimimetics use on mineral bone disorders and calcimimetics gastrointestinal tolerability in our HD unit. MATERIAL AND METHODS: A 12-week single-centre prospective study in HD patients treated with cinacalcet (>2 months). Two study periods: Usual outpatient use (Stage 1) and use after HD session (Stage 2). ENDPOINTS: 1) Biochemical MBD data; 2) Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal tolerability, and visual analogic scale (VAS) for satisfaction; 3) Adherence: Morisky-Green test (MG) and final tablet count (TC). RESULTS: Sixty-two HD patients. Fourteen received cinacalcet (22.5%). TEN patients were included, mean age was 60.9 years; patients had received HD for 80.9 months. Mean Charlson index: 9. Biochemical data: Stage 1 (initial vs. final): Ca 8.8 ± 0.5 vs. 9.1 ± 0.7 mg/dl (p<0.05); P 5.2 ± 0.8 vs. 4.5 ± 1.6 mg/dl, iPTH 360.3 ± 232.7 vs. 349 ± 122 pg/ml. MG: 70%. Stage 2 (initial vs. final): Ca 9.1 ± 0.7 vs. 8.8 ± 0.6 mg/dl; P 4.5 ± 1.6 vs. 4.6 ± 1.3 mg/dl, iPTH 360.3 ± 232.7 vs. 349 ± 122 pg/ml. TC: 89%. GSRS and VAS were better in Stage 2 (GSRS 7.5 ± 5.2 vs. 4.3 ± 1.9; VAS 4.8 ± 2.3 vs. 6.9 ± 2.8). No significant changes were observed in calcimimetic dose (201 vs. 207 mg/wk), number of phosphate binders (9 vs. 8.2 pts/day), native vitamin D (70 vs. 60%), selective vit D receptor activators (30%), or suitable dialysis parameters. CONCLUSIONS: Post-dialysis use of calcimimetic was effective in secondary hyperparathyroidism control, improved gastrointestinal tolerability and ameliorated patients' satisfaction. Based on our findings, post-dialysis use of calcimimetics should be considered in selected patients with low therapeutic compliance. SN - 1989-2284 UR - https://wwww.unboundmedicine.com/medline/citation/26306967/Administration_of_calcimimetics_after_dialysis:_same_effectiveness_better_gastrointestinal_tolerability_ L2 - http://www.revistanefrologia.com/es/linksolver/ft/ivp/0211-6995/35/403 DB - PRIME DP - Unbound Medicine ER -