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Effect of cinacalcet cessation on hyperparathyroidism in kidney transcaplant patients after long-term dialysis therapy

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Abstract

Background

Cinacalcet is a promising therapy widely used in dialysis patients with hyperparathyroidism resistant to conventional therapy. However, reports regarding the influence of cinacalcet cessation after long-term use on kidney transplantation patients are few.

Methods

This retrospective observational study included 40 dialysis patients who underwent kidney transplantation. Creatinine, corrected calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone levels were assessed before and after kidney transplantation according to pretransplant treatment of chronic kidney disease–mineral and bone disorder.

Results

Ultrasonography revealed enlargement of the parathyroid in all patients treated with cinacalcet. Although the data at the time of kidney transplantation were comparable, the serum levels of calcium, alkaline phosphatase, and intact parathyroid hormone after kidney transplantation were higher in patients treated with cinacalcet than in those treated without. However, serum phosphate levels in the cinacalcet group were slightly higher at the time of kidney transplantation and significantly lower 3 months later.

Conclusions

Mineral abnormalities persisted in kidney transplant patients with enlarged parathyroid glands after discontinuation of cinacalcet treatment. Parathyroidectomy should be considered in kidney transplant candidates with the risk of developing refractory hyperparathyroidism after transplantation.

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Acknowledgments

A portion of this work was presented at the 49th ERA-EDTA Congress, Paris, France in May 2012.

Conflict of interest

SN received a research grant from Kyowa Hakko Kirin Co. Ltd., Japan. Others, none declared.

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Authors and Affiliations

  1. Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Kentaro Nakai, Hideki Fujii, Mikiko Yoshikawa, Keiji Kono, Yuriko Yonekura, Shunsuke Goto & Shinichi Nishi

  2. Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan

    Takeshi Ishimura, Masashi Takeda & Masato Fujisawa

Authors
  1. Kentaro Nakai
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  2. Hideki Fujii
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  3. Mikiko Yoshikawa
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  4. Keiji Kono
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  5. Yuriko Yonekura
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  6. Shunsuke Goto
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  7. Takeshi Ishimura
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  8. Masashi Takeda
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  9. Masato Fujisawa
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  10. Shinichi Nishi
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Corresponding author

Correspondence to Hideki Fujii.

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Nakai, K., Fujii, H., Yoshikawa, M. et al. Effect of cinacalcet cessation on hyperparathyroidism in kidney transcaplant patients after long-term dialysis therapy. Clin Exp Nephrol 19, 1184–1188 (2015). https://doi.org/10.1007/s10157-015-1107-1

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  • DOI: https://doi.org/10.1007/s10157-015-1107-1

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