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Zavvos,; Fyssa, L; Papasotiriou, Marios; Papachristou, Evangelos; Ntrinias, Theodoros; Savvidaki, Eirini; Ds, Goumenos

doi:10.6002/ect.2016.0342

Cited by 10 publications

(6 citation statements)

References 44 publications

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“…Cinacalcet appears to be a promising therapeutic option for patients with persistent hypercalcemia post transplantation at least as a bridging agent before parathyroidectomy. [848586]…”

Section: Persistent Hyperparathyroidism After Kidney Transplantationmentioning

confidence: 99%

Secondary and tertiary hyperparathyroidism in chronic kidney disease: An endocrine and renal perspective

Chandran

Wong

2019

Indian J Endocr Metab

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Secondary Hyperparathyroidism (SHP) seen as a frequent complication in Chronic Kidney Disease (CKD) has many pathogenetic peculiarities that are still incompletely defined and understood. During the long course of chronic renal failure, SHP can also transform sometimes into the hypercalcemic state characterized by quasi-autonomous production of Parathyroid Hormone from the parathyroid glands: a disorder that is termed Tertiary Hyperparathyroidism. The clinical consequences of SHP in CKD are protean, encompassing bone and mineral abnormalities but as recently identified, also several metabolic and cardiovascular problems, the most important of which is vascular calcification. There have been several advances in the therapeutic armamentarium available for the treatment of SHP, though clear demonstration of a benefit regarding major clinical outcomes with any of the new agents is still lacking. This narrative review summarizes the current understanding about this disorder and highlights some of the recent research on the subject.

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“…Cinacalcet appears to be a promising therapeutic option for patients with persistent hypercalcemia post transplantation at least as a bridging agent before parathyroidectomy. [848586]…”

Section: Persistent Hyperparathyroidism After Kidney Transplantationmentioning

confidence: 99%

Secondary and tertiary hyperparathyroidism in chronic kidney disease: An endocrine and renal perspective

Chandran

Wong

2019

Indian J Endocr Metab

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“…The intact PTH level decreased by 7.68 pmol/L at 6 months (P not significant); however, intact PTH level decreased further by 20.07 pmol/L at the end of follow up ( p < 0.01). Serum phosphate level increased significantly and eGFR remained stable throughout follow-up [ 39 ].…”

Section: Medical Management and Treatment Options Of Persistent Post-mentioning

confidence: 99%

Management of Post-transplant Hyperparathyroidism and Bone Disease

Santos

Rossi

Coyne

et al. 2019

Drugs

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Significant advances in immunosuppressive therapies have been made in renal transplantation, leading to increased allograft and patient survival. Despite improvement in overall patient survival, patients continue to require management of persistent post-transplant hyperparathyroidism. Medications that treat persistent hyperparathyroidism include vitamin D, vitamin D analogues, and calcimimetics. Medication side effects such as hypocalcemia or hypercalcemia, and adynamic bone disease, may lead to a decrease in the drugs. When medical management fails to control persistent post-transplant hyperparathyroidism, treatment is a parathyroidectomy. Surgical techniques are not uniform between centers and surgeons. Undergoing the surgery may include a subtotal technique or a technique including total parathyroid gland resection with partial heterotopic gland reimplantation. In addition, there are possible post-surgical complications. The ideal treatment for persistent post-transplant hyperparathyroidism is the treatment and prevention of the condition while patients are being managed for their late-stage chronic kidney disease and end-stage renal disease.

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“…Zavvos et al also conducted a study including the results of a five-year follow-up with cinacalcet treatment. They also showed that calcium decreased significantly, phosphorus increased, PTH levels decreased over time, and renal functions were preserved [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Cinacalcet on Post-transplantation Hypercalcemia and Hyperparathyroidism in Adult Kidney Transplant Patients: A Single-Center Experience

Alpay¹,

Yıldız²

2023

Cureus

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Objective: Secondary hyperparathyroidism may manifest as hypercalcemia in the post-transplant period. The classical treatment method is parathyroidectomy and the alternative is oral cinacalcet, a calcimimetic agent therapy. We retrospectively investigated the effect of cinacalcet therapy on kidney and patient survival in these patients.Materials and methods: In our single-center, retrospective, observational study, files of 934 patients who underwent renal transplantation in our unit between 2008 and 2022 were reviewed. A total of 23 patients were started on cinacalcet for the treatment of hypercalcemia (calcium > 10.3 mg/dl) and parathyroid hormone (PTH) elevation (>65 pg/ml). Patients with calcium < 10.3 mg/dl and PTH > 700 pg/ml at any time in the follow-up after renal transplantation were included in the study. In addition, the demographic data of the patients, baseline creatine, calcium, phosphorus, and PTH levels at the time of hypercalcemia, parathyroid ultrasonography, parathyroid scintigraphy, creatinine, calcium, phosphorus, and PTH levels in the last controls, and survival status were evaluated.Results: The mean age of 23 patients included in the study was 52.7 ± 11 years (minimum: 32; maximum: 66). Of the patients, 16 (69.6%) were male, and 15 (65.2%) were transplanted from a living donor. Parathyroid scintigraphic revealed adenoma in three (13%) patients, hyperplasia in five patients (21.7%), and no involvement in 15 patients (65.2%). Cinacalcet treatment was initiated at a median of 33 months (interquartile range (IQR) = 13-96) after the kidney transplant operation. There was no graft loss in the patients during the follow-up period. Twenty-two patients (95.7%) were alive, and one patient died. The calcium level of the patients decreased from 11.3 ± 0.64 mg/dl to 9.98 ± 0.78 mg/dl (p = 0.001) after cinacalcet treatment. Phosphorus values increased from 2.7 ± 0.65 mg/dl to 3.10 ± 0.65 mg/dl (p = 0.004). On the other hand, there was no significant difference in PTH levels between the initial and final controls (285 (IQR = 150-573) vs. 260 pg/ml (IQR = 175-411), p = 0.650). Also, creatinine levels were similar (1.2 ± 0.38 vs. 1.24 ± 0.48 mg/dl, p = 0.43). Despite cinacalcet treatment, calcium levels did not decrease in eight patients. Complications such as renal dysfunction and pathological fracture did not develop in these patients.Conclusions: It seems that cinacalcet treatment is a suitable option for patients with hypercalcemia and/or hyperparathyroidism with low drug interactions and good biochemical control after renal transplantation.

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Cited by 10 publications

References 44 publications

Secondary and tertiary hyperparathyroidism in chronic kidney disease: An endocrine and renal perspective

Secondary and tertiary hyperparathyroidism in chronic kidney disease: An endocrine and renal perspective

Management of Post-transplant Hyperparathyroidism and Bone Disease

Effects of Cinacalcet on Post-transplantation Hypercalcemia and Hyperparathyroidism in Adult Kidney Transplant Patients: A Single-Center Experience

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