The cost-effectiveness of extended-release calcifediol versus paricalcitol for the treatment of secondary hyperparathyroidism in stage 3-4 CKD.

CONCLUSIONS: This model demonstrated favorable short- and long-term clinical benefits associated with the use of ERC in patients with CKD Stage 3 and 4 with SHPT and VDI, suggesting ERC may be cost-effective from the Medicare perspective compared to paricalcitol. PMID: 31726882 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research

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CONCLUSION: Recurrence of sHPTH after PTX remains a problem, occurring in every fifth patient. In our experience, the introduction of intraoperative PTH measurement has helped to lower the rates of persistence and recurrence. Further reductions in the recurrence rate might be achieved with novel, more accurate pre- and intraoperative imaging techniques. PMID: 31800966 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Abstract INTRODUCTION: Severe uncontrolled secondary hyperparathyroidism and kidney transplantation history are both risk factors for fractures in hemodialyzed patients. Moreover, patients who return to dialysis after transplant failure have more severe infections/anemia and higher mortality risk than transplant-naive patients starting dialysis with native kidneys. In this context, our aim was to test the hypothesis that transplant failure patients have more secondary hyperparathyroidism than transplant-naive patients. METHODS: We retrospectively compared 29 transplant failure patients to 58 transpl...
Source: Nephrologie and Therapeutique - Category: Urology & Nephrology Authors: Tags: Nephrol Ther Source Type: research
ConclusionThe parathyroid oxyphil cell proportion was associated with preoperative PTH and total weight of removed parathyroid glands in the patients with CKD. Patients with more parathyroid oxyphil proportion had lower preoperative PTH level and smaller total weight of the removed parathyroid glands.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Authors: Cozzolino M, Ketteler M Abstract Introduction: Extended-release calcifediol (ERC) is an orally administered prohormone of active vitamin D (1,25-dihydroxyvitamin D [1,25D]) designed to safely and sufficiently increase serum total 25-hydroxyvitamin D (25D) to reduce elevated parathyroid hormone (PTH) in patients with non-dialysis-chronic kidney disease (ND-CKD). ERC is currently approved in the United States and Canada.Areas covered: Herein, key clinical data relating to the pharmacokinetics, pharmacodynamics, efficacy and safety of ERC are reviewed.Expert opinion: Currently available treatment options for ...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
DiscussionThe causal inference and pathophysiology of LVH regression by FGF23 reduction using calcimimetic treatment has not yet been shown. This intervention study has the potential to discover a new strategy for the treatment of cardiac hypertrophy and fibrosis in patients on maintenance hemodialysis. It might be speculated that successful treatment of cardiac morphology will also reduce the risk of cardiac death in this population.Trial registrationEuropean Clinical Trials Database, EudraCT number 2017-000222-35; ClinicalTrials.gov,NCT03182699. Registered on
Source: Trials - Category: Research Source Type: clinical trials
Cinacalcet for secondary hyperparathyroidism in end-stage renal disease patients below age 5 years
. Clin Nephrol. 2019 Oct 07;: Authors: Joseph C, Shah S, Geer J, Juarez-Calderon M, Srivaths PR, Swartz SJ Abstract BACKGROUND: Management of chronic kidney disease mineral bone disorder (CKD-MBD) in pediatric patients with end-stage renal disease (ESRD) is challenging. While the use of calcimimetics is well-studied in adults on dialysis, few studies have been performed in pediatrics. Little is known about the use of cinacalcet in young children with ESRD. The aim of this study was to report the effica...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
ConclusionsWe found that among individuals with stage 3 and 4 CKD, PTH was an independent predictor of fractures, vascular events, and death. Additional epidemiologic studies are needed to confirm these findings. If a target PTH range can be confirmed, then randomized placebo-controlled trials will be needed to confirm that treating HPT reduces the risk of fracture, vascular events, and death.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractBackgroundSecondary hyperparathyroidism (SHPT) is a common and serious complication of chronic kidney disease, particularly in end-stage renal disease. Currently, both cinacalcet and vitamin D are used to treat SHPT via two different mechanisms, but it is still unclear whether the combination use of these two drugs can be a safe and effective alternative to vitamin D alone. Therefore, the aim of this meta-analysis was to assess the efficacy and safety of cinacalcet plus vitamin D in the treatment of SHPT.MethodsFour electronic databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENT...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
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
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 o...
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
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