Effect of cinacalcet cessation in renal transplant recipients with persistent hyperparathyroidism

Kruse, Anja E; Eisenberger, Ute; Frey, Felix J; Mohaupt, Markus G (2007). Effect of cinacalcet cessation in renal transplant recipients with persistent hyperparathyroidism. Nephrology, dialysis, transplantation, 22(8), pp. 2362-5. Oxford: Oxford University Press 10.1093/ndt/gfm270

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BACKGROUND: Persistent hyperparathyroidism after renal transplantation affects bone and allografts. Cinacalcet, a calcimimetic, reduces serum calcium and PTH in renal transplant recipients with persistent hyperparathyroidism. Here, we address the question whether this effect of cinacalcet persists after withdrawal. METHODS: Therefore, cinacalcet was stopped after 12 months treatment in 10 stable renal transplant patients. Serum calcium, phosphate, PTH, creatinine and cystatin C were monitored for 3 months. RESULTS: Serum calcium, normalized in nine patients before cessation of cinacalcet (2.32 +/- 0.05mmol/l, mean +/- SEM), increased after 3 months of discontinuation by 0.17 +/- 0.04mmol/l, P < 0.05, but remained within the normal range in eight patients. Compared with the time point of cessation, PTH remained unchanged or decreased further after 3 months without therapy in six patients. Measurements of cystatin C suggested an improvement of the glomerular filtration rate after cessation in 9 out of 10 patients (1.55 +/- 0.09 vs 1.33 +/- 0.12 mg/l, P < 0.01). CONCLUSION: First, a beneficial effect of cinacalcet beyond the duration of a 12-month therapy appears to be present in some patients and second, the previously suspected influence of cinacalcet therapy on renal function is reversible. Thus, it is reasonable to consider a trial of cinacalcet cessation to identify these patients. The optimal time point for such a discontinuation is unknown. The present observations are preliminary. They clearly require a prospective randomized trial for definitive confirmation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

UniBE Contributor:

Kruse, Anja; Eisenberger, Ute; Frey, Felix Julius and Mohaupt, Markus

ISSN:

0931-0509

ISBN:

17510094

Publisher:

Oxford University Press

Language:

English

Submitter:

Markus Georg Mohaupt

Date Deposited:

04 Oct 2013 14:54

Last Modified:

27 Apr 2018 09:11

Publisher DOI:

10.1093/ndt/gfm270

PubMed ID:

17510094

Web of Science ID:

000249243500041

BORIS DOI:

10.7892/boris.23001

URI:

https://boris.unibe.ch/id/eprint/23001 (FactScience: 38527)

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