Effectiveness and safety of activated vitamin D combined with cinacalcet in the treatment of secondary hyperparathyroidism in hemodialysis patients

Objective To explore the effectiveness and safety of activated Vitamin D combined with cinacalcet in the treatment of secondary hyperparathyroidism (SHPT) in maintenance hemodialysis (MHD) patients. Methods Thirty patients with SHPT were enrolled to receive treatment of cinacalcet combined with calcitriol. The duration of MHD was >3 months and the frequency of dialysis was 2-3 times a week. All patients were given cinacalcet 25-75 mg/day and calcitriol 0.25 μg/day. Serum Ca, P, parathyroid hormone (iPTH) and volume of parathyroid glands were measured before and 1, 3 and 6 months after treatment. The drug toxicity and clinical side effects were recorded. The experimental data were analyzed statistically by SPSS 17.0. Results After treatment, serum P, iPTH and Ca×P product decreased significantly, and serum Ca increased obviously, as compared with those before the treatment (P<0.05). After 1, 3 and 6 months of treatment, serum Ca levels increased obviously as compared with those before the treatment. There was no significant difference between each time quantum (P>0.05). After 3 and 6 months of treatment, the volume of parathyroid was reduced in 9 of 14 parathyroid hyperplasia patients, but there was no significant difference before and after treatment (P>0.05). No new parathyroid hyperplasia was found in 16 patients without parathyroid hyperplasia before treatment. There was no severe drug toxicity and clinical side effects in all patients. Conclusions Activated vitamin D combined with cinacalcet can effectively inhibit the secretion of PTH, improve the disturbance of calcium and phosphorus metabolism, and suppress or alleviate the parathyroid hyperplasia, and has no serious adverse reaction. Only a few patients had nausea and vomiting, abdominal pain and myalgia. The overall effect of activated vitamin D combined with cinacalcet is safe and reliable, and it is worthy of clinical promotion.