Decreases in parathyroid gland volume after cinacalcet treatment in hemodialysis patients with secondary hyperparathyroidism.

Abstract

BACKGROUND/AIM:

Cinacalcet, an allosteric modulator of the calcium-sensing receptor, effectively reduces serum parathyroid hormone (PTH). It was examined whether a regression of parathyroid glands in hemodialysis patients with secondary hyperparathyroidism was induced by cinacalcet treatment.

METHODS:

Ultrasonography of the parathyroid glands was performed to examine the changes in the parathyroid gland volumes after cinacalcet treatment in 58 patients.

RESULTS:

After cinacalcet treatment, serum calcium, phosphate, alkaline phosphatase, and intact PTH significantly decreased (p < 0.0001). The total volumes of the parathyroid glands were significantly decreased 6 months after cinacalcet treatment (942 +/- 747 vs. 708 +/- 550 mm(3), p < 0.0005). There was a significant positive correlation between the parathyroid gland volumes at the start of cinacalcet treatment and the volume reduction in parathyroid glands (r = 0.716, p < 0.0001). Of the 58 patients, the total parathyroid gland volume was decreased in 42 patients and increased in 16 although the doses of cinacalcet, phosphate binders or vitamin D were not significantly different. In both groups, the intact PTH serum levels were significantly decreased after cinacalcet treatment.

CONCLUSION:

Cinacalcet treatment in patients with secondary hyperparathyroidism significantly reduced the total parathyroid gland volume in a short 6-month period. This study suggests that cinacalcet treatment may postpone parathyroidectomy and/or reduce cases.

• Authors: Mitsuru Ichii, Eiji Ishimura, Senji Okuno, Hidenori Chou, Yoko Kato, Naoki Tsuboniwa, Kyoko Nagasue, Kiyoshi Maekawa, Tomoyuki Yamakawa, Masaaki Inaba, Yoshiki Nishizawa
• Journal: Nephron. Clinical practice (Nephron Clin Pract) Vol. 115 Issue 3 Pg. c195-202 ( 2010) ISSN: 1660-2110 [Electronic] Switzerland
• PMID: 20413997 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2010 S. Karger AG, Basel.

Chemical References

• Naphthalenes
• Cinacalcet

Topics

• Aged
• Cinacalcet
• Female
• Follow-Up Studies
• Humans
• Hyperparathyroidism, Secondary (diagnostic imaging, drug therapy, etiology)
• Kidney Failure, Chronic (complications, drug therapy, pathology)
• Male
• Middle Aged
• Naphthalenes (pharmacology, therapeutic use)
• Organ Size (drug effects)
• Parathyroid Glands (diagnostic imaging, drug effects, pathology)
• Prospective Studies
• Renal Dialysis
• Treatment Outcome
• Ultrasonography