Clinical Effects Of Cinacalcet In Renal Secondary Hyperparathyroidism

Objective To observe the clinical effects of cinacalcet in renal secondary hyperparathyroidism.Methods A total of sixty patients with renal secondary hyperparathyroidism were randomized to cinacalcet group(n=30)and control group(n=30).The cinacalce group: the initial dose of cinacalcet was 25 mg·d-1,adjusting the dose every three weeks,and the largest dose was 100 mg·d-1;the dose of calcitriol was 0.25 μg·d-1.The control group: the dose of calcitriol was 2 μg each time,twice a week,intravenous injection or oral were all allowed.The courses of two groups were 6 months.The levels of blood calcium,phosphorus,intact parathyroid hormone(i PTH)and blood routine were examined every month and the adverse reactions were recorded.Results Twenty-eight patients of the cinacalcet group completed the trial,and all patients of the control group completed.After 6 months treatment,82% of the cinacalcet group and 37% of the control group achieved targets in i PTH(P<0.01),100% and 43% in blood calcium respectively(P<0.01),50% and 10% in blood phosphorus respectively(P<0.01).Compared with those before treatment,the levels of blood calcium,phosphorus and calcium-phosphorus product were all decreased significantly in the cinacalce group(P<0.01),which were all increased in the control group(P<0.01),with very significant difference between two groups(P<0.01).The levels of i PTH were all decreased in both groups(P<0.01),and showed greater in the cinacalce group(P<0.01).39.29% of subjects in cinacalcet group simultaneouslyachieved targets for Ca、P、i PTH,which was 3.33% in control group(P=0.001).The proportion of subjects in cinacalcet group had a ≥30% reduction in i PTH was 100%,which was 96.67% in control group,but this was not statistically significant(P=1.000).One patient withdrew from the treatment because of gastrointestinal intolerance in the cinacalcet group.No adverse reactions occurred in the control group.Conclusions The effect of cinacalcet in reducing i PTH level is better than calcitriol shock therapy for renal secondary hyperparathyroidism patients.At the same time,cinacalcet can decrease the levels of blood calcium,phosphorus and calcium-phosphorus product,and it is also secure.