The impact of cinacalcet in the mineral metabolism markers of patients on dialysis with severe secondary hyperparathyroidism.

This study aimed to assess the safety and effectiveness of cinacalcet in managing chronic dialysis patients with severe SHPT. METHODS: This retrospective study included 26 patients [age: 52 ± 12 years; 55% females; time on dialysis: 54 (4-236) months] on hemodialysis (N = 18) or peritoneal dialysis (N = 8) with severe SHPT (intact parathyroid hormone (iPTH) level> 600 pg/mL) and hyperphosphatemia and/or persistent hypercalcemia treated with cinacalcet. The patients were followed for 12 months. Their serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and iPTH levels were measured at baseline and on days 30, 60, 90, 180, and 365. RESULTS: Patients with hyperphosphatemia (57.7%), hypercalcemia (23%), or both (19.3%) with iPTH> 600 pg/mL were prescribed cinacalcet. At the end of the study, decreases were observed in iPTH (1348 ± 422 vs. 440 ± 210 pg/mL; p
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research

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AbstractSecondary hyperparathyroidism is a frequent complication of chronic kidney disease that begins early in the course of renal insufficiency as an adaptive response to maintain mineral homeostasis. This complex disorder affects the bone, leading to an increase in fracture risk and is associated with increased risks of vascular calcification and mortality.Purpose of ReviewIn this review, we examine the different strategies available to manage secondary hyperparathyroidism. Particularly, we focus on the adequate control of serum phosphorus by restricting intake and the use of phosphate binders, correction of hypocalcemi...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research
Conditions:   Chronic Kidney Disease (CKD);   Secondary Hyperparathyroidism (SHPT) Intervention:   Drug: Paricalcitol Sponsor:   AbbVie Not yet recruiting
Source: - Category: Research Source Type: clinical trials
Introduction: Calciphylaxis is characterized by calcification of the small and medium caliber vessels of the dermis and subcutaneous cellular tissue. It is more common in patients with chronic kidney disease (CKD) on dialysis, but is also described in patients with other risk factors such as secondary hyperparathyroidism, heart failure (HF), diabetes mellitus type 2 (DM-2), hypercoagulable states and drugs such as warfarin. The mortality rate is high, with sepsis being the most frequent complication.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Sustained loss of kidney function leads to the evolution of progressive secondary hyperparathyroidism associated with a characteristic high-turnover form of metabolic bone disease. The drivers of hyperparathyroidism include the failure of renal bioactivation of vitamin D, phosphate retention and, in some cases, hypocalcaemia. As renal impairment becomes more severe, some patients, particularly under the influence of treatment, and particularly if they have diabetes, evolve in a different direction, with the development of low-turnover adynamic bone disease associated with relative suppression of the parathyroid glands.
Source: Medicine - Category: Internal Medicine Authors: Tags: Chronic kidney disease Source Type: research
This article aims to compile existing research, provide an overview of current practice with regard to PTX and post-PTX chronic management. It highlights gaps and controversies and aims to re-orient the focus to clinically relevant contemporary priorities in CKD-MBD management after PTX. PMID: 31313380 [PubMed - as supplied by publisher]
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research
AbstractSecondary hyperparathyroidism (SHPT) is a major complication of chronic kidney disease (CKD), responsible for skeletal and vascular damage with increased risk of bone fractures, cardiovascular events, and mortality. However, the optimal serum parathormone (PTH) levels for improving clinical outcomes remain uncertain. Treatment of SHPT is based on nutritional therapy, phosphate binders, vitamin D, and calcimimetics, but none of these interventions has ever been tested against placebo in randomized controlled trials. Treatment of SHPT in the elderly should consider the many peculiarities of aging in terms of physiopa...
Source: Drugs and Aging - Category: Geriatrics Source Type: research
Authors: Dreyer P, Ohe MN, Santos LM, Kunii IS, Santos RO, Carvalho AB, Vieira JG Abstract INTRODUCTION: Hyperparathyroidism is a frequent complication of chronic kidney disease (CKD). Total parathyroidectomy (PTX) with parathyroid tissue autotransplantation (AT) is a treatment option in those individuals that do not respond to clinical management. OBJECTIVE: To evaluate grafted parathyroid tissue response during induced hypocalcemia among CKD patients who underwent total PTX with AT. METHODS: Eighteen patients with renal hyperparathyroidism were submitted to total PTX with parathyroid AT selected by stereo...
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
CONCLUSION: While treatment principles are similar to other dialysis patient groups, physicians should be aware of the special problems of the elderly group. PMID: 26702005 [PubMed - in process]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Authors: Peride I, ChecheriŢă IA, Smarandache DR, Rădulescu D, Sinescu RD, Niculae A, Pricop C Abstract Vascular calcifications represent a severe complication of secondary hyperparathyroidism in patients with chronic kidney disease (CKD) stage 5. The factors influencing the development of this complication are in close relation with the pathology of chronic dialysis premorbid condition, and with therapy as well. The present article highlights the association between several factors and the development or the aggravation of vascular calcifications in continuous ambulatory peritoneal dialysis (CAPD) patients. The...
Source: Romanian Journal of Morphology and Embryology - Category: Journals (General) Tags: Rom J Morphol Embryol Source Type: research
CONCLUSION: The incidence of secondary hyperparathyroidism was detected in 40/61 patients (66%) with chronic kidney disease using scintigraphy and 16 patients (40%) from them underwent surgery. MIBI SPECT/low dose CT with 3D dual - tracer subtraction (MIBI-Tc) method is an effective tool for preoperative detection of the parathyroid glands hyperplasia or adenoma. PMID: 24824800 [PubMed - indexed for MEDLINE]
Source: Endocrine Regulations - Category: Endocrinology Tags: Endocr Regul Source Type: research
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