Observation of the patients with secondary hyperparathyroidism taking the sequential treatment of cinacalcet and active vitamin D

Abstract

Objective Safety and effectiveness were evaluted in order to investigate maintenance hemodialysis patients with secondary hyperparathyroidism taking cinacalcet, active vitamin D sequential treatment by observating a group of clinical cases. Methods In our hospital 15 maintenance hemodialysis patients with secondary hyperparathyroidism take cinacalcet due to high calcium, high phosphorus (Ca×P>75 mg2/dl2), and high parathyroid hormone, 12 of which parathyroid hormone (PTH) decreased by 30%, and the serum calcium or phosphorus were also decreased compared with the previous (Ca×P<65 mg2/dl2), and now switch to the active vitamin D for 2 months.Compare the serum calcium, phosphorus, parathyroid hormone, Ca×P levels of the 12 patients brefor and after taking active vitamin D. Results After using active vitamin D, 2 patients withdrew the observation because of elevated PTH. One case was found elevated PTH (1077 vs 1540 pg/ml) two weeks later then did the parathyroidectomy; another was found elevated PTH (877 vs 1034 pg/ml) after dressing one month, and restored cinacalcet treatment. (parathyroid hormone PTH) of the other 10 patients (83.3%, 10/12) continued to decline (375.3±194.90) g/ml, (1182.92±392.3) vs (807.62±308.97) pg/ml, t=2.377, P=0.029), Ca×P rised but be lower than the previous 70 mg2/dl2, there was no significant difference (49.30±3.85) vs (52.71±3.63) mg2/dl2,t=-0.643, P=0.528), the serum total calcium increased slightly (2.17±0.13) vs (2.35±0.18)mmol/L, t=-2.539, P=0.021), there was no significant change in serum phosphorus (1.84±0.51) vs (1.81±0.45)mmol/L, t=0.125, P=0.902). Conclusion Cinacalcet, active vitamin D sequential therapy may continue to reduce parathyroid hormone, calcium and phosphorus load is not significantly increase. Key words: Secondary hyperparathyroidism; Active vitamin D; Cinacalcet; Sequential treatment