Short- and middle-term continuous use of cinacalcet in children on peritoneal dialysis

Secondary hyperparathyroidism (HPT) constitute a high-turnover bone disease, manifested by elevated parathyroid hormone. Cinacalcet, belonging to calcimimetics, has been shown to be promising in the control of secondary HPT with limited data in children.

To evaluate the safety and efficacy of cinacalcet in children on peritoneal dialysis (PD) with secondary HPT.

Four patients on PD with severe secondary HPT, uncontrolled with phosphorus dietary restrictions combined with phosphate binders and analog of 1,25 vitamin D3 received cinacalcet.

After cinacalcet treatment, in two of four patients, we found a serum intact parathyroid hormone (iPTH) level reduction by more than 70% at 4 weeks and more than 60% at 3 or more than 6 months. Nevertheless, in the other two patients, a transient reduction of iPTH was found in 4 weeks and an increase in 3 or more months, who were finally treated with surgical parathyroidectomy. During cinacalcet treatment, no adverse events were noted.

Cinacalcet may be a safe and effective treatment for PD patients with secondary HPT, although surgical parathyroidectomy cannot be avoided in certain cases.