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Cinacalcet is efficacious in pediatric dialysis patients
Douglas M Silverstein1, Kanwal K Kher, Asha Moudgil
1Children's National Medical Center, Washington, DC, USA. dsilvers@cnmc.org
Pediatric Nephrology (Berlin, Germany)
|February 22, 2008
Summary
Cinacalcet effectively reduced high parathyroid hormone (PTH) levels in pediatric patients with secondary hyperparathyroidism undergoing dialysis. This treatment also lowered alkaline phosphatase without negatively impacting calcium, phosphorus, or blood pressure.
Area of Science:
- Nephrology
- Pediatric Endocrinology
- Bone Metabolism
Background:
- Secondary hyperparathyroidism (high-turnover bone disease) is characterized by elevated parathyroid hormone (PTH) levels.
- Standard treatments like phosphate control and vitamin D therapy are not always sufficient for managing high PTH in pediatric dialysis patients.
Purpose of the Study:
- To evaluate the efficacy of the calcimimetic cinacalcet in pediatric patients with secondary hyperparathyroidism undergoing hemodialysis (HD) or peritoneal dialysis (PD).
Main Methods:
- Nine pediatric patients (ages 7.5-17.5 years) with high-turnover bone disease received cinacalcet at doses of 30-120 mg/day.
- Treatment outcomes were assessed by measuring intact PTH (iPTH), alkaline phosphatase, serum calcium, phosphorus, and blood pressure before and after cinacalcet administration.
Main Results:
- Cinacalcet treatment led to a significant 61% decline in iPTH levels (p = 0.005) and a reduction in serum alkaline phosphatase.
- Serum calcium, phosphorus, calcium-phosphorous product, blood pressure, and hemoglobin levels remained stable during treatment.
- Patients on PD required lower doses of calcitriol, and HD patients required lower doses of paracalcitol while on cinacalcet.
Conclusions:
- Short-term treatment with cinacalcet is effective in reducing elevated PTH levels in adolescent dialysis patients with secondary hyperparathyroidism.
- Cinacalcet offers a potential therapeutic option for managing high-turnover bone disease in pediatric dialysis populations.
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