Autor(es):
Macário, F 
; Frazão, JM ; Ferreira, A ; Weigert, A ; Mota, M ; Machado, D ; Birne, R ; Neto, R ; Baldaia Moreira, A ; Soares, C ; Ribeiro, S ; Mendes, T ; Alves, R ; Gomes, H ; Raposo, H
Data: 2009
Identificador Persistente: http://hdl.handle.net/10400.17/1028
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): Hiperparatiroidismo Secundário; Portugal; Hemodiálise; Estudos Retrospectivos; Estudos Prospectivos
Descrição
Secondary hyperparathyroidism is a common
complication of chronic kidney disease. The elevated serum intact parathyroid hormone, phosphorus, calcium and calcium x phosphorus product have been independently associated with an increased relative risk of mortality. The standard therapy for secondary
hyperparathyroidism, including active vitamin D analogues and phosphate binders, is often insufficient to allow patients to achieve the recommended Kidney Disease Outcomes Quality Initiative targets for bone and mineral metabolism. Randomised controlled
phase III clinical studies in chronic kidney
disease patients with secondary hyperparathyroidism have shown that cinacalcet treatment increases the
proportion of patients achieving the recommended Kidney Disease Outcomes Quality Initiative targets for intact parathyroid hormone, phosphorus, calcium and calcium x phosphorus product. Aims: This observational multicentre study aims to evaluate cinacalcet’s ability to achieve and maintain
Kidney Disease Outcomes Quality Initiative
targets in a population with secondary hyperparathyroidism on chronic haemodialysis in Portugal.
Patients and Methods: Patients on chronic dialysis that received cinacalcet during a free sampling programme were enrolled. Retrospective and prospective monthly data were collected from 3 months before until 6 months after the beginning of cinacalcet
treatment. Additional assessment included a
12 month evaluation of all parameters.
Results: 140 dialysis patients with secondary
hyperparathyroidism were enrolled, 60% male, mean age 57.4±14.1 years. The mean intact parathyroid hormone, calcium, phosphorus, and calcium x phosphorus product values at baseline were 751.7±498.8 pg/ml, 9.7±3.8 mg/dl, 5.5±1.5 mg/dl, and 52.7±25.3
mg2/dl2, respectively.
After 6 months’ cinacalcet treatment, 26.2%,
53.6%, 59.3%, and 81.0% of the patients achieved the Kidney Disease Outcomes Quality Initiative recommended levels for intact parathyroid hormone, calcium, phosphorus, and calcium x phosphorus product, respectively. The mean dose of cinacalcet
at 6 months was 57.1±29.7 mg/day.
Conclusions: The use of cinacalcet in clinical practice is an effective option for the treatment of secondary hyperparathyroidism in chronic dialysis
patients, allowing more patients to reach and maintain the Kidney Disease Outcomes Quality Initiative targets.
