| Theme | Cinacalcet hydrochloride | |
|---|---|---|
| Title | Parathyroid intervention therapy and cinacalcet hydrochloride for advanced secondary hyperparathyroidism due to chronic kidney disease | |
| Publish Date | 2008/04 | |
| Author | Yoshihiro Tominaga | Department of Transplant and Endocrine Surgery, Nagoya Second Red Cross Hospital |
| [ Summary ] | Cinacalcet hydrochloride should have an impact on the treatment of secondary hyperparathyroidism (HPT) due to chronic kidney disease (CKD) in Japan. However, there are many issues to be resolved about the treatment. Special consideration should be made as to efficacy of cinacalcet hydrochloride for treatment of nodular hyperplasia, in relation to parathyroid intervention therapy. Parathyroidectomy (PTx) can dramatically control secondary HPT in most cases. However, surgeons hesitate to perform this operation on patients who belong to high risk groups having the possibility of severe complications, ie bilateral recurrent nerve palsy. Sometimes removal of the parathyroid gland located ectopically, especially in the mediastinum, may be invasive. Parathyroid carcinoma or parathyromatosis often can not be controlled even through surgical measures. Cinacalcet hydrochloride may be indicated for these patients, producing a remarkable decrease in high PTH levels. Calcimimetics are available in the USA and European countries for patients with uncontrollable hypercalcemia due to parathyroid carcinoma. In Japan the acceptance of this medicine for parathyroid carcinoma is expected soon. After the induction of cinacalcet hydrochloride, successful surgical treatment may also be required. |
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