Use of cinacalcet in nephrolithiasis associated with normocalcemic or hypercalcemic primary hyperparathyroidism: results of a prospective randomized pilot study.

To evaluate, by means of a prospective randomized study, the efficacy of cinacalcet in the forms of nephrolithiasis associated with primary hyperparathyroidism in both the hypercalcemic and normocalcemic variant.
Ten patients suffering from active nephrolithiasis associated with primary hyperparathyroidism (4 hypercalcemics and 6 normocalcemics), equally divided between males and females, were randomly but not blindly addressed to treatment with potassium citrate and allopurinol, or to the same therapeutic regimen in combination with cinacalcet. The dosage of cinacalcet was optimized for each patient in order to obtain a reduction of parathyroid hormone (PTH) within normal limits while enabling the maintenance of adequate calcemic values. All study participants were given the same diet based on a reduction in sodium intake, oxalate-rich foods and animal protein with standardized intake of calcium and an increase in hydration. After a follow up period of 10 months , cinacalcet was associated to standard therapy and diet in patients who were not taken it, conversely cinacalcet was withdrawn in the remaining patients who remained on standard therapeutic regimen and diet. Follow up was continued for a second period of observation of the same duration of the first.
At the end of the period of treatment with cinacalcet, for both variants of hyperparathyroidism, a statistically significant reduction in the overall number and in the diameter of renal stones was found.
This prospective randomized study shows the effectiveness of cinacalcet used in combination with a diet with normalized calcium intake, in reducing the number and size of urinary stones in hypercalemic and normocalcemic forms of primary hyperparathyroidism.
AuthorsSimone Brardi, Gabriele Cevenini, Tiziano Verdacchi, Giuseppe Romano, Roberto Ponchietti
JournalArchivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia (Arch Ital Urol Androl) Vol. 87 Issue 1 Pg. 66-71 (Mar 2015) ISSN: 1124-3562 [Print] Italy
PMID25847900 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Calcimimetic Agents
  • Naphthalenes
  • Cinacalcet Hydrochloride
  • Allopurinol
  • Potassium Citrate
  • Aged
  • Allopurinol (therapeutic use)
  • Calcimimetic Agents (therapeutic use)
  • Cinacalcet Hydrochloride
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Hypercalcemia (drug therapy, etiology)
  • Hyperparathyroidism, Primary (complications, diet therapy, drug therapy)
  • Male
  • Middle Aged
  • Naphthalenes (therapeutic use)
  • Nephrolithiasis (complications, drug therapy)
  • Pilot Projects
  • Potassium Citrate (therapeutic use)
  • Prospective Studies
  • Treatment Outcome

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