Treatment of renal hyperparathyroidism: Cinacalcet or surgery?

Abstract

Patients with end-stage renal disease have a 30%-50% incidence of hyperparathyroidism. Renal hyperparathyroidism causes multiple systemic diseases, which affect the life quality of patients, and seriously endangers patients’ life. Now there are two major treatments, Cinacalcet and surgery. This article is aimed to discuss the characteristics of the two methods and review the latest research on renal hyperparathyroidism. It is advised that Cinacalcet may apply to: 1, patients with mild to moderate secondary hyperparathyroidism; 2, patients who do not accept the surgery; 3, patients with surgical contraindication. And surgical procedures are applicable to: 1, patients with tertiary hyperparathyroidism after kidney transplantation; 2, patients with invalid Cinacalcet treatment; 3, patients who cannot tolerate the side-effect of Cinacalcet; 4, patients unable to undertake economic burden of Cinacalcet. However, these conclusions still require higher levels of clinical trials to be validated. Key words: Renal hyperparathyroidism; Second hyperparathyroidism; Tertiary hyperparathyroidism; Cinacalcet; Parathyroidectomy