Effects of cinacalcet on achieving the targets listed in the guidelines of the Japanese Society for Dialysis Therapy

Arimura Tetsuro, Isono Motohide, Ohhashi Seiji, Kondoh Morihiro, Shikano Tsutomu, Tomita Kohbin, Nishio Toshiji, Nishimura Masataka, Hatta Tsuguru, Nishio Toshiki, Nagasaku Daisuke, Kume Shinji, Isshiki Keiji, Uzu Takashi

doi:10.4009/jsdt.43.787

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Other Title

慢性血液透析患者におけるシナカルセトのＪＳＤＴガイドライン達成率への影響　　‐びわこ臨床透析カンファレンス共同研究‐
慢性血液透析患者におけるシナカルセトのJSDTガイドライン達成率への影響--びわこ臨床透析カンファレンス共同研究
マンセイケツエキトウセキカンジャニオケルシナカルセトノ JSDT ガイドラインタッセイリツエノエイキョウビワコリンショウトウセキカンファレンスキョウドウケンキュウ
―びわこ臨床透析カンファレンス共同研究―

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Abstract

Aim : We evaluated the impact of cinacalcet on achieving the targets listed in the guidelines of the Japanese Society for Dialysis Therapy (JSDT) [phosphate (P) 3.5～6.0 mg/dL, corrected calcium (Ca) 8.4～10.0 mg/dL and intact parathyroid hormone (iPTH) 60～180 pg/mL]. Patients and methods : We examined the medical records of 52 hemodialyzed Japanese patients who were treated with cinacalcet between January and December 2008. Cinacalcet was discontinued in 5 patients due to adverse effects and iPTH levels were not followed in 1 patient. Therefore, we analyzed data from 46 patients. Results : During the follow-up periods, 24 patients achieved iPTH levels within the target range and 19 patients achieved the target ranges for P, Ca and iPTH (group A). Baseline iPTH levels were significantly different between group A and patients who did not achieve the target levels of P, Ca or iPTH (group NA) (353±124 pg/mL vs. 668±383 pg/mL, p<0.01). The baseline Ca level was also significantly lower in group A than in group NA. Of patients with baseline intact PTH level≤500 pg/mL, 78% achieved the target iPTH level and 63% were classified into group A. Of patients with baseline iPTH>500 pg/mL, 16% achieved the target iPTH level and 11% were classified into group A. Parathyroid gland size, which was measured by ultrasonography in 5 patients, was significantly reduced from the baseline to week 24 (580±349 mm³ vs. 357±254 mm³, p=0.03). Conclusion : The presence of a low iPTH level (180～500 pg/mL) without elevated Ca level predicts a good response to cinacalcet. Cinacalcet may also be effective in patients with enlarged parathyroid glands.

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 43 (9), 787-794, 2010

The Japanese Society for Dialysis Therapy

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