ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2022, Vol. 31 ›› Issue (6): 514-518.DOI: 10.3969/j.issn.1006-298X.2022.06.003

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The observational study of paricalcitol combine with cinacalcet in treatment of hemodialysis patients with refractory secondary hyperparathyroidism

  

  • Online:2022-12-28 Published:2023-01-04

Abstract: Objective:To observe efficacy and safety of paricalcitol combin with cinacalcet in treatment of refractory secondary hyperparathyroidism(SHPT)in maintenance hemodialysis(MHD) patients.
Methodology:A retrospective study was conducted in MHD patients with SHPT whose serum intact parathyroid hormone (iPTH) was still >800 pg/mL, although treated with calcitriol and cinacalcet, Serum levels of calcium, phosphorus, iPTH, alkaline phosphatase, calcium phosphorus product and hemoglobin were measured at baseline, 4 and 12 weeks after treatment.
Results:Twelve patients were enrolled in this study(6 males and 6 females), the baseline iPTH was 129165±37096 pg/mL, serum calcium was 225±029 mmol/L, and serum phosphorus was 212±058 mmol/L. The initial dose of paricalcitol is 5 μg, tiw, combined with cinacalcet 25~50 mg/d. After 4 weeks of treatment, iPTH decreased to 89557 ± 47942 pg/mL(P=0054), the proportion of patients with iPTH reduction rate>30% and with iPTH reduction to 150~585 pg/mL was 333% and 25% respectively; After 12 weeks of treatment, iPTH level was 79491±41712 pg/mL(P=0011), the proportion of patients with iPTH reduction rate>30% and with iPTH reduction to 150~585 pg/mL was 583% and 333% respectively. The mean decline rate of iPTH was 3659±2448%(22%~919%). Compared with the baseline, there was no statistical difference with serum phosphorus and calcium during follow up. No adverse events were observed.
Conclusion:Paricalcitol combined with cinacalcet can reduce the level of iPTH in MHDSHPT patients safely and effectively.

Key words: paricalcitol, cinacalcet, secondary hyperparathyroidism, hemodialysis