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Cinacalcet for Severe Secondary Hyperparathyroidism in Children with End-stage Kidney Disease

Areej Adel Sheerah1, Rafif Ali Al-Ahmed1, Sherif M El-Desoky2

  • 1Department of Pediatrics, Pediatric Nephrology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|August 10, 2022
PubMed

Insights

Cinacalcet effectively treats severe secondary hyperparathyroidism in children with end-stage kidney disease. This treatment significantly lowered parathyroid hormone levels without serious side effects, offering a safe therapeutic option.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Mineral and Bone Disorders

Background:

  • Advanced chronic kidney disease (CKD) often presents with mineral and bone disorders (MBD).
  • Controlling serum bone profile (parathyroid hormone, calcium, phosphorus) is challenging in pediatric end-stage kidney disease (ESKD).
  • Secondary hyperparathyroidism (SHPT) significantly impacts bone health, growth, and cardiovascular outcomes in children with ESKD.

Purpose of the Study:

  • To evaluate the efficacy and safety of cinacalcet for treating refractory SHPT in pediatric ESKD patients.
  • To assess the impact of cinacalcet on serum intact parathyroid hormone (iPTH) levels.

Main Methods:

  • Retrospective observational study.
  • Comparison of 14 children treated with cinacalcet versus 22 children receiving standard care.
  • Data collected over a 6-month treatment period.

Main Results:

  • Cinacalcet treatment led to a significant mean reduction in serum iPTH by 56% (from 202 to 88 pmol/L).
  • The reduction in iPTH levels was statistically significant compared to the control group (P <0.001).
  • No serious adverse effects or hypocalcemia were reported in the cinacalcet group.

Conclusions:

  • Cinacalcet is an effective and safe treatment for severe SHPT in children with ESKD.
  • It offers a promising alternative for managing refractory SHPT.
  • Further large-scale, long-term studies are warranted to confirm safety and efficacy.

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