Cinacalcet May Aid in Bone Remodeling After Renal Transplantation

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Cinacalcet treatment following renal transplantation is associated with improved bone remodeling.
  • The indication for cinacalcet therapy was persisting hyperparathyroidism and declining renal function as well as nephrocalcinosis in transplant biopsy.
  • Decreasing serum calcium and increasing serum phosphate along with increasing BAP signal a positive effect of cinacalcet on bone remodeling after renal transplantation.

Cinacalcet treatment following renal transplantation is associated with improved bone remodeling, a study found.

Anke Schwarz, MD, and colleagues at Hannover Medical School in Hannover, Germany, studied 35 renal transplant patients before and after the start of cinacalcet therapy (30-60 mg for a mean of 7.9 months starting 4.7 years after transplantation).

The indication for cinacalcet therapy was persisting hyperparathyroidism and declining renal function as well as nephrocalcinosis in transplant biopsy.

Serum calcium decreased (2.6 vs. 2.4 mmol/L) and serum phosphate increased (1.0 vs. 1.2 mmol/L) after cinacalcet therapy. Both findings were significant.

Parathyroid hormone decreased and serum creatinine increased nonsignificantly. Bone-specific alkaline phosphatase (BAP) increased significantly from 15 to 30 μg/L, which is above the normal range (7-20), while osteocalcin and telopeptide remained unchanged within normal ranges. BAP correlated significantly with PTH and serum creatinine. Osteocalcin did not correlate with any of the parameters.

Decreasing serum calcium and increasing serum phosphate along with increasing BAP signal a positive effect of cinacalcet on bone remodeling after renal transplantation, even though PTH does not decrease significantly, the authors concluded.

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