PTH-dependence of the effectiveness of cinacalcet in hemodialysis patients with secondary hyperparathyroidism
- Akizawa, Tadao
- Kurita, Noriaki
- Mizobuchi, Masahide
- Fukagawa, Masafumi
- Onishi, Yoshihiro
- Yamaguchi, Takuhiro
- Ellis, Alan R.
- Fukuma, Shingo
- Alan Brookhart,
- Hasegawa, Takeshi
- Kurokawa, Kiyoshi
- Fukuhara, Shunichi
DOIAbstract
Cinacalcet lowers parathyroid hormone levels. Whether it can prolong survival of people with chronic kidney disease (CKD) complicated by secondary hyperparathyroidism (SHPT) remains controversial, in part because a recent randomized trial excluded patients with iPTH <300 pg/ml. We examined cinacalcet’s effects at different iPTH levels. This was a prospective case-cohort and cohort study involving 8229 patients with CKD stage 5D requiring maintenance hemodialysis who had SHPT. We studied relationships between cinacalcet initiation and important clinical outcomes. To avoid confounding by treatment selection, we used marginal structural models, adjusting for time-dependent confounders. Over a mean of 33 months, cinacalcet was more effective in...
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