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Renal function in patients treated with cinacalcet for persistent hyperparathyroidism after kidney transplantation.

Author(s): Henschkowski J, Bischoff-Ferrari HA, Wuthrich RP, Serra AL

Affiliation(s): Center on Aging and Mobility, University Hospital, University of Zurich, Ramistrasse 100, Switzerland.

Publication date & source: 2011, Kidney Blood Press Res., 34(2):97-103. Epub 2011 Jan 27.

Publication type: Meta-Analysis

BACKGROUND AND AIM: Cinacalcet effectively reduces calcium in patients with persistent hyperparathyroidism (HPT) after kidney transplantation. We aimed to assess the association of cinacalcet with a decrease in renal function based on a meta-analysis of observational studies in kidney transplant patients with persistent HPT. METHOD: Meta-analysis of observational studies, no randomized controlled studies were available. We calculated the mean difference between renal function before cinacalcet and at 3 months on cinacalcet treatment for each study. Pooled analyses are based on random effects models. RESULTS: Pooling the studies on kidney transplant patients with persistent HPT (8 studies, n = 115), we found a significant reduction in renal function (p = 0.008). The effect size was 5 mumol/l (p < 0.0001) when pooling the 7 studies where serum creatinine levels were reported. Meta-regression analysis revealed that there was an association between renal function and the amount of calcium reduction under treatment with cinacalcet. A higher delta change in serum calcium levels was associated with a decrease in renal function at 3 months of cinacalcet treatment. CONCLUSION: Cinacalcet treatment was associated with a decline of renal function in kidney transplant recipients with persistent HPT. Our meta-analysis underscores the need for frequent monitoring of creatinine and calcium levels during cinacalcet treatment. Copyright (c) 2011 S. Karger AG, Basel.

Page last updated: 2011-12-09

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