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Kidney Blood Press Res. 2011;34(2):97-103. doi: 10.1159/000323902. Epub 2011 Jan 27.

Renal function in patients treated with cinacalcet for persistent hyperparathyroidism after kidney transplantation.

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1
Center on Aging and Mobility, University Hospital, University of Zürich, Rämistrasse 100, Switzerland.

Abstract

BACKGROUND AND AIM:

Cinacalcet effectively reduces calcium in patients with persistent hyperparathyroidism (HPT) after kidney transplantation. We aimed to assess the association of cinacalcet with a decrease in renal function based on a meta-analysis of observational studies in kidney transplant patients with persistent HPT.

METHOD:

Meta-analysis of observational studies, no randomized controlled studies were available. We calculated the mean difference between renal function before cinacalcet and at 3 months on cinacalcet treatment for each study. Pooled analyses are based on random effects models.

RESULTS:

Pooling the studies on kidney transplant patients with persistent HPT (8 studies, n = 115), we found a significant reduction in renal function (p = 0.008). The effect size was 5 μmol/l (p < 0.0001) when pooling the 7 studies where serum creatinine levels were reported. Meta-regression analysis revealed that there was an association between renal function and the amount of calcium reduction under treatment with cinacalcet. A higher delta change in serum calcium levels was associated with a decrease in renal function at 3 months of cinacalcet treatment.

CONCLUSION:

Cinacalcet treatment was associated with a decline of renal function in kidney transplant recipients with persistent HPT. Our meta-analysis underscores the need for frequent monitoring of creatinine and calcium levels during cinacalcet treatment.

PMID:
21273790
DOI:
10.1159/000323902
[Indexed for MEDLINE]
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