| Series | Clinical Investigation | |
|---|---|---|
| Title | Effects of cinacalcet hydrochloride on radial bone mineral density in hemodialysis patients with secondary hyperparathyroidism | |
| Publish Date | 2011/01 | |
| Author | Yoko Watanabe | Division of Nephrology, Saitama Tsukinomori Clinic |
| Author | Fumihiko Yasuda | Division of Nephrology, Saitama Tsukinomori Clinic |
| Author | Satoshi Kurihara | Division of Nephrology, Saitama Tsukinomori Clinic |
| Author | Yasuhiko Iino | Division of Neurology, Nephrology and Rheumatology, Nippon Medical School |
| Author | Yasuaki Katayama | Division of Neurology, Nephrology and Rheumatology, Nippon Medical School |
| [ Summary ] | Parathyroidectomies (PTx) dramatically increase bone mineral density (BMD) in hemo-dialysis patients with secondary hyperparathyroidism (II°HPT). However, it is yet to be definitively determined, whether medical PTx with cinacalcet hydrochloride (cinacalcet) administration increases BMD. Our group measured radial BMD with DEXA in seven HD patients before and one year after treatment with cinacalcet (25-50 mg/day). Serum intact parathyroid hormone (i-PTH) decreased from 381.3±147.5 to 186.9±47.6 pg/ml at 3 months Tx and stayed at about the same level over the next nine months. Serum bone specific alkaline phosphatase and bone gla-protein concentrations signifi cantly decreased at 1 year Tx. The Z-score (age-matched BMD) and T-score (young-adult mean matched BMD) both increased at 1 year Tx, but not to statistically significant levels. On the other hand, the Z-score and T-score both slightly decreased at 1 year in three patients with high serum PTH (400 pg/ml) who had received only vitamin D. These results suggest that cinacalcet administration for HD patients with II°HPT not only effectively suppresses PTH oversecretion and improves bone metabolism, but also restores loss of BMD due to ostitis fibrosa. Additional follow up studies over longer periods are needed |
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