Cinacalcet treatment for secondary hyperparathyroidism (SHPT) in men on chronic hemodialysis (HD) is associated with decreased serum total and free testosterone, according to a small study.

Piotr Kuczera, MD, and colleagues at the Medical University of Silesia in Katowice, Poland, studied the effect of 6 months of treatment with cinacalcet on serum total and free teosterone in 38 male HD patients with SHPT, defined as a serum parathyroid hormone (PTH) level above 300 pg/mL.

Among 33 patients who completed the study, cinacalcet treatment was associated with a significant decrease in mean serum PTH level from 1,143 pg/mL at baseline to 607 pg/mL after 6 months of treatment, the researchers reported in Kidney & Blood Pressure Research (2016;41:1-8). During the same period, serum total testosterone decreased significantly from 4.95 to 4.39 ng/mL and serum free testosterone decreased significantly from 6.95 to 5.60 pg/mL, respectively. These decreases were associated with the magnitude of serum PTH decrease and dose of cinacalcet, according to the investigators.

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Cinacalcet treatment, the investigators noted, may lead to an increased prevalence of testosterone insufficiency and perhaps deficiency, which is associated with comorbidities such as insulin resistance, type 2 diabetes, hypertension, and atherosclerosis.

The investigators acknowledged limitations of their study, including the lack of a placebo group and the relatively small sample size.