Open label study to assess the safety and efficacy of cinacalcet in refractory hyperparathyroidism with chronic renal failure

Reema Thottol, M. Sreelatha, PV Narayanan


Background: Secondary hyperparathyroidism a common consequence of chronic kidney disease is associated with many complications like renal osteodystrophy, vascular and soft tissue calcification. This study is to assess the safety and efficacy of Cinacalcet a calcimimetic drug in patients with refractory hyperparathyroidism due to chronic renal failure.

Methods: Patients with chronic kidney disease stage 5 on maintenance haemodialysis diagnosed to have refractory hyperparathyroidism who do not attain the target range for hyper-parathyroid indicators serum PTH ≤300, Serum Ca (8.4-9.5), serum phosphorous (3.5-5.5) with the use of calcitriol and phosphate binders were included in the study. Twenty patients satisfying the case definition of refractory hyperparathyroidism due to chronic renal failure received 30mg Cinacalcet therapy. Total duration of treatment was 6 weeks. Standard serum calcium, serum phosphorous, PTH was assessed before and after 6 weeks.

Results: Cinacalcet significantly reduces serum PTH level when results were compared by paired t test. P=0.016 <0.05 (significant). No statistically significant reduction in serum calcium and phosphorous. Serum calcium P value=0.599>0.05, serum phosphorous P=0.132>0.05. In this study after overall assessment.

Conclusions: Cinacalcet is more efficacious and safe in treating refractory hyperparathyroidism due to chronic renal failure.


Hyperparathyroidism, Cinacalcet, Calcitriol, Phosphate binders, Calcimimetic, Parathormone

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