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TANG Li, LIAO Chang-bin, Zhang Jia-li. Preliminary exploration of the role of parathyroid volume in predicting the efficacy of cinacalcet on secondary hyperparathyroidism[J]. Journal of Clinical Nephrology, 2020, 20(10): 819-824. DOI: 10.3969/j.issn.1671-2390.2020.10.010
Citation: TANG Li, LIAO Chang-bin, Zhang Jia-li. Preliminary exploration of the role of parathyroid volume in predicting the efficacy of cinacalcet on secondary hyperparathyroidism[J]. Journal of Clinical Nephrology, 2020, 20(10): 819-824. DOI: 10.3969/j.issn.1671-2390.2020.10.010
shu

Preliminary exploration of the role of parathyroid volume in predicting the efficacy of cinacalcet on secondary hyperparathyroidism

  • Department of Nephrology, Zigong Third People's Hospital, Zigong 643000, China

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  • Received Date: March 12, 2020
  • Available Online: May 11, 2023
  • Published Date: October 27, 2020
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    • Abstract
  • Objective To divide maintenance hemodialysis(MDH)patients with secondary hyperparathyroidism(SHPT)into various groups according to their parathyroid volumes,and preliminarily explore the role of parathyroid volume in predicting the efficacy of cinacalcet on SHPT by observing efficacy of cinacalcet in various groups.Methods Sixty-seven MHD patients with SHPT from Zigong Third People's Hospital were selected and divided into three groups according to the maximum parathyroid volume:group A(parathyroid volume<500 mm3,21 cases),group B(500 mm3 ≤ parathyroid volume<1 000 mm3,23 cases),group C(parathyroid volume ≥ 1 000 mm3,23 cases).The initial dose of cinacalcet was 25 mg/day and increased gradually up to 100 mg/day to achieve the control goal covering the intact parathyroid hormone(iPTH)levels(150~300 pg/mL).The main observation index was iPTH compliance rate(150~300 pg/mL),and the secondary observation index was the rate of iPTH decline more than 30%.The changes in serum iPTH,corrected calcium and serum phosphorus were observed during the follow-up period of 24 weeks.Results One patient in group B fell off,and three in group C.The remaining patients were followed up for 24 weeks.There were no significant differences in baseline age,gender,calcium and phosphorus levels between the three groups.The baseline dialysis age of patients in group C was significantly longer than that in group A and B,with statistically significance.The levels of iPTH in the three groups before treatment were statistically different.After 24 weeks of treatment,the levels of serum calcium and serum iPTH in the three groups were significantly declined(P<0.05).The proportions of iPTH decreased by more than 30% in the three groups were high,with no statistically significant differences between the three groups.The iPTH compliance rate was 81% in group A,45.5% in group B and 10% in group C(P<0.05).In this study,29 of 63 patients met the standard of iPTH.Multiple regression analysis indicated that the maximum parathyroid volume before treatment and the pre-treatment iPTH were independent predictors of whether iPTH complied with the standard.Conclusions Cinacalcet had good efficacy in the treatment of SHPT in hemodialysis patients.Baseline maximum parathyroid volume and iPTH are independent predictors of iPTH compliance.
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  • [1]
    Moe SM,Drüeke T,Lameire N,et al.Chronic kidney disease-mineral-bone disorder:a new paradigm[J].Adv Chronic Kidney Dis,2007,14(1):3-12.DOI: 10.1053/j.ackd.2006.10.005.
    [2]
    Aladrén Regidor MJ.Cinacalcet reduces vascular and soft tissue calcification in secondary hyperparathyroidism(SHPT)in hemodialysis patients[J].Clin Nephrol,2009,71(2):207-213.DOI: 10.5414/cnp71207.
    [3]
    Fukagawa M,Kitaoka M,Inazawa T,et al.Imaging of the parathyroid in chronic renal failure:diagnostic and therapeutic aspects[J].Curr Opin Nephrol Hypertens,1997,6(4):349-355.DOI: 10.1097/00041552-199707000-00007.
    [4]
    Fukagawa M,Kitaoka M,Kurokawa K.Ultrasonographic intervention of parathyroid hyperplasia in chronic dialysis patients:a theoretical approach[J].Nephrol Dial Transplant,1996,11(supp3):125-129.DOI: 10.1093/ndt/11.supp3.125.
    [5]
    Tanaka M,Itoh K,Matsushita K,et al.Combination therapy of intravenousmaxacalcitol and percutaneous ethanol injection therapy lowers serum parathyroid hormone level and calcium×phosphorus product in secondary hyperparathyroidism[J].Nephron Clin Pract,2005,102(1):c1-c7.DOI: 10.1159/000088163.
    [6]
    Moe SM,Chertow GM,Coburn JW,et al.Achieving NKF-K/DOQI bone metabolism and disease treatment goals with cinacalcet HCl[J].Kidney Int,2005,67(2):760-771.DOI: 10.1111/j.1523-1755.2005.67139.x.
    [7]
    Messa P,Macário F,Yaqoob M,et al.The OPTIMA study:assessing a new cinacalcet(sensipar/mimpara)treatment algorithm for secondary hyperparathyroidism[J].Clin J Am Soc Nephrol,2008,3(1):36-45.DOI: 10.2215/cjn.03591006.
    [8]
    Torun D,Yildiz I,Micozkadioglu H,et al.The effects of cinacalcet treatment on bone mineral metabolism,anemia parameters,left ventricular mass index and parathyroid gland volume in hemodialysis patients with severe secondary hyperparathyroidism[J].Saudi J Kidney Dis Transpl,2016,27(1):15.DOI: 10.4103/1319-2442.174053.
    [9]
    Vulpio C,Bossola M,Magalini SC,et al.Parathyroid-gland ultrasonography in clinical and therapeutic evaluation of renal secondary hyperparathyroidism[J].La Radiol Med,2013,118(5):707-722.DOI: 10.1007/s11547-012-0882-x.
    [10]
    Nemeth EF,Steffey ME,Hammerland LG,et al.Calcimimetics with potent and selective activity on the parathyroid calcium receptor[J].PNAS,1998,95(7):4040-4045.DOI: 10.1073/pnas.95.7.4040.
    [11]
    Zitt E,Jäger C,Rosenkranz AR,et al.Effective use of cinacalcet for the treatment of secondary hyperparathyroidism in Austrian dialysis patients-Results of the Austrian cohort of the ECHO study[J].Wien Klin Wochenschr,2011,123(1/2):45-52.DOI: 10.1007/s00508-010-1515-x.
    [12]
    周露,赵文琪,叶婷,等.西那卡塞联合活性维生素D治疗维持性血液透析继发性甲状旁腺功能亢进症的疗效观察[J].中国中西医结合急救杂志,2017,24(6):650-653.DOI: 10.3969/j.issn.1008-9691.2017.06.021.
    [13]
    张新,周焕,王晓慧,等.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的临床观察[J].临床肾脏病杂志,2018,18(3):156-159.DOI: 10.3969/j.issn.1671-2390.2018.03.006.
    [14]
    Sekercioglu N,Busse JW,Sekercioglu MF,et al.Cinacalcet versus standard treatment for chronic kidney disease:a systematic review and meta-analysis[J].Ren Fail,2016,38(6):857-874.DOI: 10.3109/0886022X.2016.1172468.
    [15]
    周凌辉,张恒远,裴娟,等.长疗程西那卡塞治疗维持性血液透析患者难治性继发性甲状旁腺功能亢进症的临床观察[J].中国全科医学,2018,21(8):989-992.DOI: 10.3969/j.issn.1007-9572.2018.08.022.
    [16]
    Zitt E,Fouque D,Jacobson SH,et al.Serum phosphorus reduction in dialysis patients treated with cinacalcet for secondary hyperparathyroidism results mainly from parathyroid hormone reduction[J].Clin Kidney J,2013,6(3):287-294.DOI: 10.1093/ckj/sft026.
    [17]
    Okuno S,Inaba M,Ishimura E,et al.Effects of long-term cinacalcet administration on parathyroid gland in hemodialysis patients with secondary hyperparathyroidism[J].Nephron,2019,142(2):106-113.DOI: 10.1159/000496808.
    [18]
    Susantitaphong P,Vadcharavivad S,SusomboonT,et al.The effectiveness of cinacalcet:a randomized,open label study in chronic hemodialysis patients with severe secondary hyperparathyroidism[J].Ren Fail,2019,41(1):326-333.DOI: 10.1080/0886022X.2018.1562356.
    [19]
    Fukagawa M,Yumita S,Akizawa T,et al.Cinacalcet(KRN1493)effectively decreases the serum intact PTH level with favourable control of the serum phosphorus and calcium levels in Japanese dialysis patients[J].Nephrol Dial Transplant,2008,23(1):328-335.DOI: 10.1093/ndt/gfm534.
    [20]
    Mei CL,Chen N,Ding XQ,et al.Efficacy and safety of Cinacalcet on secondary hyperparathyroidism in Chinese chronic kidney disease patients receiving hemodialysis[J].HemodialInt Int Symp Home Hemodial,2016,20(4):589-600.DOI: 10.1111/hdi.12410.
    [21]
    Komaba H,Nakanishi S,Fujimori A,et al.Cinacalcet effectively reduces parathyroid hormone secretion and gland volume regardless of pretreatment gland size in patients with secondary hyperparathyroidism[J].Clin J Am Soc Nephrol,2010,5(12):2305-2314.DOI: 10.2215/CJN.02110310.
    [22]
    Kawata T,Imanishi Y,Kobayashi K,et al.Direct in vitro evidence of the suppressive effect of cinacalcet HCl on parathyroid hormone secretion in human parathyroid cells with pathologically reduced calcium-sensing receptor levels[J].J Bone Miner Metab,2006,24(4):300-306.DOI: 10.1007/s00774-006-0687-y.
    [23]
    Schneider R,Kolios G,Koch BM,et al.An economic comparison of surgical and medical therapy in patients with secondary hyperparathyroidism:the German perspective[J].Surgery,2010,148(6):1091-1099.DOI: 10.1016/j.surg.2010.09.009.
    [24]
    Hirai T,Nakashima A,Takasugi N,et al.Association of nodular hyperplasia with resistance to cinacalcet therapy for secondary hyperparathyroidism in hemodialysis patients[J].Ther Apher Dial,2010,14(6):577-582.DOI: 10.1111/j.1744-9987.2010.00843.x.
    [25]
    Fukagawa M,Kitaoka M,Kurokawa K.Resistance of the parathyroid glands to vitamin D in renal failure:implications for medical management[J].Kidney Int Suppl,1997,62:S60-S64.
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