Open AccessResearch Article Efficacy of Cinacalcet for the Treatment of Secondary Hyperparathyroidism in CKD Patients on Peritoneal or Hemo Dialysis: The Middle-East Experience

Background: Management of secondary hyperparathyroidism is challenging with traditional therapy. The calcimimetic cinacalcet hydrochloride acts on the calcium-sensing receptors to increase its sensitivity to calcium, thereby reducing parathyroid hormone (PTH) secretion. Calcimimetics lower parathyroid hormone levels without increasing calcium and phosphorus levels. Aim: To evaluate effectiveness of cinacalcet hydrochloride in reducing serum intact PTH levels in patients with end stage renal diseases and secondary hyperparathyroidism. Material methods: The study included patients who were receiving regular dialysis and had inadequately controlled secondary hyperparathyroidism despite standard treatment (calcium based phosphorus binders and/or sevlamer carbonate at ceiling doses with or without vitamin D sterols- 1,25(OH)2-vitamin D). They were assigned to receive cinacalcet (Group I, n = 69; 45 on hemodialysis and 24 on peritoneal dialysis) or their usual drugs without cinacalcet (Group II, n = 40; 20 on hemodialysis and 20 on peritoneal dialysis) for 12 months. Once-daily doses of cinacalcet hydrochloride was increased from 30 mg to 180 mg to achieve intact parathyroid hormone levels of < 300 pg/ml. Serum calcium, phosphorous and iPTH were monitored before starting cinacalcet, at 3 months, 6 months and 12 months