Original Report: Patient-Oriented, Translational Research

Long-Term Outcomes of Cinacalcet and Paricalcitol Titration Protocol for Treatment of Secondary Hyperparathyroidism
Eric Lazar, Katrina Hebert, Tammy Poma, Nicole Stankus

Department of Medicine, University of Chicago, Chicago, Ill., USA

Address of Corresponding Author

Am J Nephrol 2007;27:274-278 (DOI: 10.1159/000101727)

  Key Words

• Vitamin D
• End-stage renal disease
• Osteodystrophy
• Cinacalcet

  Abstract

Long-term outcomes of combined cinacalcet and paricalcitol therapy for secondary hyperparathyroidism (SHPT) in patients failing traditional therapies with phosphate binders and active vitamin D compound analogs are not well described. We implemented a titration protocol for cinacalcet and paricalcitol and assessed its long-term effects on bone metabolism and disease in hemodialysis (HD) patients. Thirty-five patients were started on 30 mg of cinacalcet daily. After 12 months, median cinacalcet dose was 60 mg. There was a 33% increase in number of patients receiving paricalcitol. Average corrected serum calcium (Ca) decreased from 9.5 to 8.8 mg/dl (p = 0.003, 95% CI 0.34-1.04); phosphorus (P) from 6.2 to 5.5 mg/dl (p = 0.047, 95% CI 0.01-1.34); Ca × P product from 58 to 48 (p = 0.001, 95% CI 4.2-15.7); and intact PTH (iPTH) from 426 ± 274 to 300 ± 228 pg/ml (p = 0.03, 95% CI 19.3-401.7). Number of patients achieving three or more K/DOQI criteria increased by 29% (p = 0.009).

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Nicole Stankus, MD
Department of Medicine
University of Chicago, 5841 S. Maryland Avenue MC 5100
Chicago, IL 60637 (USA)
Tel. +1 773 702 3630, Fax +1 773 702 5818, E-Mail nstankus@medicine.bsd.uchicago.edu

  Article Information

Received: August 10, 2006
Accepted: March 12, 2007
Published online: April 12, 2007
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 22