[Cinacalcet in the therapy of secondary hyperparathyroidism--own experiences]

Secondary hyperparathyroidism (sHPT) affects 20-25% dialysed patients and is related to the bone, mineral and cardiovascular complications. Cinacalcet, acts on the calcium-sensing receptor increasing its sensitivity to calcium, thereby reducing parathyroid hormone (PTH) secretion. The aim of this study was to evaluate the effect of cinacalcet in dialysed patients with sHPT Material and methods. We studied group of 12 patients on dialysis > 3 month with sHPT and baseline iPTH > 450 pg/ml (F = 6, M = 6; peritoneal dialysis 2 patients and HD 10 patients; mean age 56 +/- 14). Cinacalcet was titrated from 30 mg once daily during a 6 month period. The following parameters were determined in serum: iPTH, Ca, P, before onset of therapy and every 4 weeks during 6 months therapy.

Serum iPTH significantly decreased after 4 weeks therapy compared to the start point (from 849 +/- 253 to 338 +/- 260 pg/ml) and after 24 weeks cinacalcet therapy to 298 +/- 153 pg/ml. (64% reduction). Serum calcium and phosphate decrease but not significantly 8.7 +/- 1.2 vs 8.6 +/- 1.1 mg/dl and 7.3 +/- 2.8 vs 6.3 +/- 1.7 mg/dl respectively. There weren't serious adverse events.

Cinacalcet is effective and well tolerated nonsurgical management treatment of secondary hyperparathyroidism in dialysed patients.