Abstract | BACKGROUND: METHODS: Dialysis patients from a single center who ceased cinacalcet between August 2015 and March 2016 were included in a prospective observational study. Bloods were taken at the time of cessation of cinacalcet and at 1, 6 and 12 months. Clinical and biochemical outcomes were compared with an age- and gender-matched cohort of cinacalcet-naïve dialysis patients. RESULTS: Sixty-two patients participated in the study. Mean age was 69.6 ± 13.2 years. Biochemical changes over 12 months following cessation of cinacalcet included an increase in serum parathyroid hormone (PTH) (42.2 [IQR 27.8-94.6] pmol/L to 114.8 [83.9-159.1] pmol/L [p < 0.001]), serum calcium (2.31 ± 0.21 mmol/L to 2.46 ± 0.14 mmol/L [p < 0.001]) and primary CPP ( CPP-I) (p = 0.002). Changes in CPP were associated with an increase in PTH (p = 0.007), calcium (p = 0.002) and ferritin (p = 0.02) but a reduction in serum albumin (p = 0.001). Over the 12-month period, there were two fractures, five cardiovascular events, one episode of calciphylaxis, and one parathyroidectomy, with a mortality rate of 19% (n = 13). CONCLUSION: Uniquely we report the effects of cinacalcet withdrawal in a real world setting with demonstrated increases in PTH, serum calcium and CPP subsets, novel CKD-MBD related factors, over a 12-month period.
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Authors | Irene Ruderman, Edward R Smith, Nigel D Toussaint, Tim D Hewitson, Stephen G Holt |
Journal | BMC nephrology
(BMC Nephrol)
Vol. 19
Issue 1
Pg. 113
(05 15 2018)
ISSN: 1471-2369 [Electronic] England |
PMID | 29764395
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Calcimimetic Agents
- Parathyroid Hormone
- Calcium
- Cinacalcet
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Topics |
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Bone Density
(drug effects, physiology)
- Calcimimetic Agents
(administration & dosage)
- Calcium
(blood)
- Cinacalcet
(administration & dosage)
- Cohort Studies
- Female
- Humans
- Hyperparathyroidism, Secondary
(blood, diagnosis, therapy)
- Longitudinal Studies
- Male
- Middle Aged
- Parathyroid Hormone
(blood)
- Prospective Studies
- Renal Dialysis
(adverse effects, trends)
- Withholding Treatment
(trends)
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