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- Title
Impact of cinacalcet pre-transplantation on mineral metabolism in renal transplant recipients.
- Authors
Sharma, Ashish K; Masterson, Rosemary; Holt, Stephen G; Tan, Sven‐Jean; Hughes, Peter D; Chu, Melissa; Jayadeva, Pavithra; Toussaint, Nigel D
- Abstract
Aim Cinacalcet is effective in reducing parathyroid hormone ( PTH) in patients on dialysis. Reports of biochemical profiles and other clinical outcomes in patients discontinuing cinacalcet at time of renal transplantation are limited. Methods A retrospective study assessing markers of mineral metabolism, graft and patient outcomes in renal transplant recipients to determine differences in patients discontinuing cinacalcet ( C+) compared with patients not treated with cinacalcet ( C−) at time of transplantation. To allow for differences between groups in pre-transplant biochemical parameters, we also analysed a matched cohort of C− with C+ recipients (2:1), matched for age, calcium and PTH levels at transplantation. Results Five hundred thirty-two recipients (460 C−, 72 C+), transplanted January 2006- December 2012, were analysed, mean age 48.0 ± 12.7 years and 64.3% were men. At a median 42.9 months follow up, there were 10 deaths (1.9%), 56 allograft loss (10.6%) and 5 parathyroidectomies post-transplant (0.8%). Median PTH immediately pre-transplant was higher in C+ versus C− (50.7(25.4-75.2) versus 28.3(13.9-49.7) pmol/L, P < 0.001). Twelve-month post-transplant PTH was reduced but higher in C+ (11.7(6.9-21.2) vs 7.2(4.6-11.2) pmol/L, P < 0.001). Mean calcium was higher for C+ versus C− at 12 months (2.50 ± 0.19 vs 2.43 ± 0.17 mmol/L, P < 0.001), with differences to 4 years post-transplant. No difference was seen in renal function, graft loss, post-transplant parathyroidectomy rate and mortality. In the matched cohort (144 C− vs 72 C+), similar findings were also seen. Conclusion Differences in mineral metabolism post-transplant are seen with cinacalcet pre-transplant compared with no cinacalcet. Transplant recipients discontinuing cinacalcet had higher post-transplant PTH and calcium although the clinical significance is unclear.
- Subjects
KIDNEY transplantation; MINERAL metabolism; PARATHYROID hormone; HEMODIALYSIS; DRUG efficacy
- Publication
Nephrology, 2016, Vol 21, Issue 1, p46
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.12536