Pediatric Nephrology

, Volume 23, Issue 10, pp 1823–1829

Cinacalcet for secondary hyperparathyroidism in children with end-stage renal disease

  • Jutta Muscheites
  • Marianne Wigger
  • Erdmute Drueckler
  • Dagmar-Christiane Fischer
  • Guenther Kundt
  • Dieter Haffner
Original Article

Abstract

The efficacy and acceptability of cinacalcet for treatment of secondary hyperparathyroidism (SHPT) was assessed in seven pediatric patients suffering from end-stage renal disease (ESRD) presenting with inadequately controlled SHPT despite conventional management. Patients received daily treatment with cinacalcet (dosage 0.25 mg/kg body weight) for a total of 4 weeks. Within 4 h after application of the first dose, median levels of serum parathyroid hormone (PTH) had decreased from 932 pg/ml (range 511–1,938 pg/ml) to 584 pg/ml (88–937 pg/ml), and final pre-dose values after 4 weeks were 199 pg/ml (121–940 pg/ml; each P < 0.05 versus baseline). Median concentrations of serum calcium (Ca) decreased within 4 h of the first administration, from 2.56 mmol/l to 2.38 mmol/l, returning to 2.58 mmol/l at 24 h, and they remained slightly decreased compared to baseline values thereafter (each P < 0.05 versus baseline). Both the median levels of serum phosphorus (P) and the Ca × P ion product decreased significantly during the 4-week period. Cinacalcet was well tolerated and without drug-related adverse effects. Thus, even with approximately half of the dose usually given to adult dialysis patients, PTH and the Ca × P ion product were markedly reduced in pediatric ESRD patients presenting with inadequately controlled SHPT. Therefore, our results support the initiation of a randomized, controlled, long-term trial in children.

Keywords

End-stage renal disease Secondary hyperparathyroidism Hyperphosphatemia Hypercalcemia Calcimimetics Cincacalcet 

Abbreviations

Alk. Ptases

alkaline phosphatase

ARPKD

autosomal-recessive polycystic kidney disease

Ca

calcium

Ca × P

calcium-phosphorus ion product

CaSR

Ca sensing receptor

CKD

chronic kidney disease

P

phosphorus

PTH

parathyroid hormone

SHPT

secondary hyperparathyroidism

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Copyright information

© IPNA 2008

Authors and Affiliations

  • Jutta Muscheites
    • 1
    • 3
  • Marianne Wigger
    • 1
  • Erdmute Drueckler
    • 1
  • Dagmar-Christiane Fischer
    • 1
  • Guenther Kundt
    • 2
  • Dieter Haffner
    • 1
  1. 1.Department of PediatricsUniversity of RostockRostockGermany
  2. 2.Department of Medical Informatics and BiometryUniversity of RostockRostockGermany
  3. 3.Department of PediatricsUniversity HospitalRostockGermany

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