Resumen

DEL VALLE, Elisa Elena et al. INITIAL EXPERIENCE WITH CINACALCET IN ARGENTINA. Rev. nefrol. dial. traspl. [online]. 2015, vol.35, n.1, pp.15-23. ISSN 2346-8548.

Introduction: Secondary Hyperparathyroidism is a frequent chronic renal disease complication. Cinacalcet, an allosteric modulator of the calcium- sensing receptor, increases its sensitivity to activation by extracellular calciumions, proved to be effective in reducing PTH levels. Objetive: To evaluate cinacalcet effectiveness in hemodialysis patients with HPTS. Materials and methods: A retrospective, multicenter, observational study was carried out, on 76 patients who received Cinacalcet for at least 3 months, as a treatment for HPTS. Results: The median age was 51±16 years old, 61% were men. 67 months (43-109) was the median time in HD previous to starting with cinacalcet. 40.8% completed one year treatment. Basal PTH median was 1110 pg/ml (887-1477). PTH levels significantly decreased from first month of treatment 874 ( t< 0.0001) to the third 729 p< 0.0001 and to the sixth month 602 p< 0.0001. From the ninth month on, they remained stable, achieving PTH objective levels in 49% of patients that concluded one year treatment. FAL significantly decreased between months 3 and 6, remaining without changes afterwards. There was a significant decrease in calcemia (9.4mg/dl basal to 9 and 8.7 p< 0.0001) and phosphatemia (5.9 mg/dl basal to 5.5 and 5.3, p< 0.0001) in the first and the third month of treatment. Initial 30 mg cinacalcet dose was significantly increased in the 3 and 6 month ( mean dose 50mg/day) but without modifications in 9 and 12 months. Conclusions: 50mg/day mean doses correct moderate SHPT but are insufficient for severe SHPT, pointing out the importance of an earlier treatment beginning, and dose tritation according to response.

Palabras clave : Hemodialysis; Secondary hyperparathyroidism; Use of cinacalcet.

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