Within this prospective, open-label, self-controlled study, we evaluated the long-term effects of the calcimimetic cinacalcet on\ncalcium and phosphate homeostasis in 44 kidney transplant recipients (KTRs) with hypercalcemic hyperparathyroidism by\ncomparing biochemical parameters of mineral metabolism between pre- and posttreatment periods. Results are described as mean\ndifferences (95% CIs) between pre- and posttreatmentmedians that summarize all repeated measurements of a parameter of interest\nbetween the date of initial hypercalcemia and cinacalcet initiation (median of 1.6 (IQR: 0.6ââ?¬â??3.8) years) and up to four years after\ntreatment start, respectively. Cinacalcet was initiated after 1.8 (0.8ââ?¬â??4.7) years posttransplant and maintained for 6.2 (3.9ââ?¬â??7.6) years. It\nsignificantly decreased total serum calcium (?0.30 (?0.34 to ?0.26)mmol/L, P < 0.001) and parathyroid hormone levels (?79 (?103\nto ?55) pg/mL, P < 0.001). Serum levels of inorganic phosphate (Pi) and renal tubular reabsorption of phosphate to glomerular\nfiltration rate (TmP/GFR) increased simultaneously (Pi: 0.19 (0.15ââ?¬â??0.23)mmol/L, P < 0.001, TmP/GFR: 0.20 (0.16ââ?¬â??0.23)mmol/L,\nP < 0.001). In summary, cinacalcet effectively controlled hypercalcemic hyperparathyroidism in KTRs in the long-term and\nincreased low Pi levels without causing hyperphosphatemia, pointing towards a novel indication for the use of cinacalcet in KTRs.
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