International Urology and Nephrology

, Volume 44, Issue 5, pp 1479–1486 | Cite as

Cinacalcet lowers FGF-23 level together with bone metabolism in hemodialyzed patients with secondary hyperparathyroidism

  • Tomasz Hryszko
  • Szymon Brzosko
  • Alicja Rydzewska-Rosolowska
  • Ewa Koc-Zorawska
  • Michal Mysliwiec
Nephrology – Original Paper



Secondary hyperparathyroidism (sHPT) is associated with elevated levels of FGF-23, which in turn are connected to adverse outcomes in ESRD patients. The relationship between FGF-23 and bone metabolism in patients with sHPT treated with cinacalcet has not been studied.


Thirty-four stable chronically hemodialyzed patients with sHPT were prospectively followed during the treatment with cinacalcet without any changes in concurrent vitamin D or phosphate binder dose. Blood samples were collected at the start and after 6 months of study. Levels of osteocalcin (OC), cross-linked C-telopeptide of type I collagen (CTX), and FGF-23 were measured.


Eighteen patients finished the study. Levels of calcium, phosphate, and iPTH decreased during 6 months of treatment with cinacalcet. Serum level of FGF-23 decreased significantly (log FGF-23 from 7.58 ± 1.7 to 6.61 ± 1.7 pg/ml) (P < 0.001). Cinacalcet lowered the concentration of CTX from 3.1 ± 0.6 ng/ml to 2.6 ± 0.9 ng/ml (P < 0.05) and OC from 91.8 (41.5–558.6) to 70.3 (11.3–419.7) ng/ml (P < 0.05). The magnitude of change in FGF-23 concentration before and after treatment correlated significantly with suppression of osteoblasts’ function assessed by ΔOC (r = 0.5, P < 0.05) but not with changes in bone resorption marker ΔCTX.


Cinacalcet treatment of sHPT results in reduction of FGF-23 levels, probably due to the suppression of osteoblasts function.


Bone metabolism Cinacalcet FGF-23 Hemodialysis Secondary hyperparathyroidism 


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Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • Tomasz Hryszko
    • 1
  • Szymon Brzosko
    • 1
  • Alicja Rydzewska-Rosolowska
    • 1
  • Ewa Koc-Zorawska
    • 1
  • Michal Mysliwiec
    • 1
  1. 1.Department of Nephrology and TransplantationMedical University of BialystokBialystokPoland

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