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https://www.readbyqxmd.com/read/29124559/hungry-bone-syndrome-two-weeks-after-starting-cinacalcet-a-call-for-caution
#1
Sahar H Koubar, Abd Assalam Qannus, Walid Medawar, Ali K Abu-Alfa
Cinacalcet is an effective and safe alternative to parathyroidectomy in end stage renal disease (ESRD) patients with secondary hyperparathyroidism. Hypocalcemia is a known complication of treatment that is usually readily reversible upon discontinuation of the drug. It rarely manifests severely and symptomatically requiring hospital admission. We present the case of a 55 year old man with severe, symptomatic and prolonged hypocalcemia that occurred 2 weeks after starting cinacalcet. Cinacalcet induced a state of pharmacological parathyroidectomy with subsequent hungry bone syndrome...
November 9, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29108515/long-term-use-of-cinacalcet-in-kidney-transplant-recipients-with-hypercalcemic-secondary-hyperparathyroidism-a-single-center-prospective-study
#2
Vasileios Zavvos, Lamprini Fyssa, Marios Papasotiriou, Evangelos Papachristou, Theodoros Ntrinias, Eirini Savvidaki, Dimitrios S Goumenos
OBJECTIVES: Persistent secondary hyperparathyroidism is common after successful kidney transplant, with concomitant hypercalcemia and hypophosphatemia potentially leading to reduced graft survival and increased cardiovascular risk. Cinacalcet, a calcimimetic agent that activates the calcium-sensing receptors in parathyroid glands, is a therapeutic option. In this study, we assessed the long-term treatment effects of cinacalcet for a period of up to 5 years in a cohort of kidney transplant recipients...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29093248/-effect-of-cinacalcet-combined-with-low-dose-calcitriol-on-clinical-outcome-and-bone-metabolism-in-patients-with-severe-secondary-hyperparathyroidism
#3
Fang Yuan, Xing Chen, Chang Wang, An Zhou, Hong Liu
To observe the clinical outcome and the effect of the combination of cinacalcet hydrochloride with low-dose calcitriol on bone metabolism in maintenance hemodialysis (MHD) patients with severe secondary hyperparathyroidism (SHPT).
 Methods: Thirty SHPT patients were enrolled to receive treatment of cinacalcet combined with low-dose calcitriol, with inclusion criteria as follows: maintenance on MHD>6 months; serum intact parathyroid hormone (iPTH)>600 pg/mL; parathyroid glands with more than 1 nodules by ultrasonography; traditional therapy with no effects...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29078759/endothelin-a-receptor-blocker-and-calcimimetic-in-the-adenine-rat-model-of-chronic-renal-insufficiency
#4
Suvi Törmänen, Ilkka Pörsti, Päivi Lakkisto, Ilkka Tikkanen, Onni Niemelä, Timo Paavonen, Jukka Mustonen, Arttu Eräranta
BACKGROUND: We studied whether endothelin receptor antagonist and calcimimetic treatments influence renal damage and kidney renin-angiotensin (RA) components in adenine-induced chronic renal insufficiency (CRI). METHODS: Male Wistar rats (n = 80) were divided into 5 groups for 12 weeks: control (n = 12), 0.3% adenine (Ade; n = 20), Ade + 50 mg/kg/day sitaxentan (n = 16), Ade + 20 mg/kg/day cinacalcet (n = 16), and Ade + sitaxentan + cinacalcet (n = 16)...
October 27, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29067991/does-combination-of-paricalcitol-with-cinacalcet-in-secondary-hyperparathyroidism-in-hemodialysis-treatment-make-sense
#5
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Tomasz Prystacki, Wojciech Marcinkowski, Teresa Dryl-Rydzyńska
INTRODUCTION    Secondary hyperparathyroidism (SHPT) is a common hormonal disorder associated with  chronic kidney disease (CKD). SHPT treatment should lead to reduction of parathormon concentration by calcimimetics or active vitamin D administration and calcium-phosphate metabolism stabilization. In the event of failure of conservative treatment complete or partial parathyroid resection should be considered.  OBJECTIVES    The aim of the study was assessement of beneficial effects of treatment with paricalcitol and cinacalcet simultaneously versus paricalcitol alone...
October 25, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29064176/calciphylaxis-after-parathyroidectomy
#6
Sathish Karmegam, Anupkumar Shetty
A 60-year-old African American man with end stage renal disease on hemodialysis (HD) for the past 2.5 years developed severe hyperparathyroidism. Other past medical history included atrial fibrillation, type II diabetes mellitus, hypertension, gout, pericardial effusion needing pericardial window, deep vein thrombosis, mitral insufficiency, and cardiomyopathy with implantable cardioversion device placement. His parathyroid hormone (PTH) level peaked at 4,191 pg/mL despite being on cinacalcet, sevelamer, and paricalcitol...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29051042/bone-disease-in-primary-hyperparathyroidism
#7
Polyzois Makras, Athanasios D Anastasilakis
Primary hyperparathyroidism (PHPT) is a disease of high bone turnover, decreased bone mineral density (BMD) especially at cortical sites, and increased risk of fractures at all skeletal sites. Early diagnosis during the last decades resulted in milder forms of bone involvement. New methods of imaging and validation such as high resolution peripheral quantitative computed tomography and trabecular bone score provide evidence of disturbed bone microarchitecture and explain further the increased risk of fractures at both cortical and trabecular skeletal sites...
October 16, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29047366/the-use-of-cinacalcet-hinders-the-diagnosis-of-parathyroid-carcinoma-in-a-chronic-dialysis-patient-a-case-report
#8
Daisuke Takada, Tatsuo Tsukamoto, Miho Fuse, Shinpei Kada, Motoko Yanagita
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving chronic dialysis therapy. Although cinacalcet can control parathyroid function and bone turnover, preventing ectopic calcification remains challenging. Cinacalcet can also suppress PTH secretion due to parathyroid carcinoma in the same way as it does for parathyroid hyperplasia in the uremic condition. We present a case of parathyroid carcinoma partially controlled by cinacalcet, in which tumorous calcinosis was successfully resolved by total parathyroidectomy...
October 18, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29046478/cinacalcet-corrects-hypercalcemia-in-mice-with-an-inactivating-g%C3%AE-11-mutation
#9
Sarah A Howles, Fadil M Hannan, Caroline M Gorvin, Sian E Piret, Anju Paudyal, Michelle Stewart, Tertius A Hough, M Andrew Nesbit, Sara Wells, Stephen Dm Brown, Roger D Cox, Rajesh V Thakker
Loss-of-function mutations of GNA11, which encodes G-protein subunit α11 (Gα11), a signaling partner for the calcium-sensing receptor (CaSR), result in familial hypocalciuric hypercalcemia type 2 (FHH2). FHH2 is characterized by hypercalcemia, inappropriately normal or raised parathyroid hormone (PTH) concentrations, and normal or low urinary calcium excretion. A mouse model for FHH2 that would facilitate investigations of the in vivo role of Gα11 and the evaluation of calcimimetic drugs, which are CaSR allosteric activators, is not available...
October 19, 2017: JCI Insight
https://www.readbyqxmd.com/read/28993865/two-year-cortical-and-trabecular-bone-loss-in-ckd-5d-biochemical-and-clinical-predictors
#10
H H Malluche, M-C Monier-Faugere, G Blomquist, D L Davenport
This prospective two-year study of patients on chronic dialysis measured changes in bone mineral density (BMD). Patients with higher baseline BMD and shorter dialysis vintage lost more bone. Treatment with anti-hypertensives acting on the central nervous system was protective against bone loss. Baseline serum levels of sclerostin and bone-specific alkaline phosphatase predicted bone loss. INTRODUCTION: This prospective 2-year study of chronic kidney disease on dialysis (CKD-5D) patients assessed trabecular and cortical bone loss at the hip and spine and examined potential demographic, clinical, and serum biochemical predictors of bone loss...
October 9, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28992983/primary-hyperparathyroidism
#11
REVIEW
Manuel Muñoz-Torres, Antonia García-Martín
Primary hyperparathyroidism (PHPT) is a common endocrinological process, characterized by chronic elevation of serum concentrations of calcium and parathyroid hormone (PTH). Many years ago, the most frequent forms of clinical presentation were symptomatic renal or skeletal disease with moderate or severe hypercalcemia; however, currently, most patients have few symptoms and mild hypercalcemia. A new form of presentation called normocalcemic PHPT has also been described but clinical consequences are not well established...
October 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28991002/estimating-the-effect-of-preventable-treatment-discontinuation-on-health-outcomes
#12
M A Brookhart, D Reams, P J Dluzniewski, A Kshirsagar, L Walsh, B D Bradbury
BACKGROUND: There is increased interest in studying the effects of medication adherence on health outcomes. However, if patients appropriately stop treatment because of side effects and treatment failure, it is neither possible nor clinically meaningful to estimate the effect of full medication adherence. METHODS: We present an analysis designed to estimate the effect of non-medical (preventable) discontinuation of cinacalcet, an oral medication approved to treat secondary hyperparathyroidism in patients with end stage renal disease on dialysis on mortality and heart failure...
October 4, 2017: Epidemiology
https://www.readbyqxmd.com/read/28980761/parathyroid-nodular-hyperplasia-and-responsiveness-to-drug-therapy-in-renal-secondary-hyperparathyroidism-an-open-question
#13
REVIEW
Carlo Vulpio, Maurizio Bossola
The goal of the pharmacological therapy in secondary hyperparathyroidism (SHPT) is to reduce serum levels of parathyroid hormone and phosphorus, to correct those of calcium and vitamin D, to arrest or reverse the parathyroid hyperplasia. However, when nodular hyperplasia or an autonomous adenoma develops, surgery may be indicated. We reviewed the literature with the aim of defining if the echographic criteria predictive of unresponsiveness of SHPT to calcitriol therapy are valid also in the cinacalcet era and if drug therapy may reverse nodular hyperplasia of parathyroid gland (PTG)...
October 5, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28979783/obesity-and-listing-for-renal-transplantation-weighing-the-evidence-for-a-growing-problem
#14
Mohammed Hossain, Alexander Woywodt, Titus Augustine, Videha Sharma
A 56-year-old female patient was referred to the transplant assessment clinic in July 2016. She started haemodialysis in 2012 for renal failure due to urinary tract infections. She is doing very well on dialysis and has an excellent exercise tolerance without shortness of breath or angina. She has had no infections since starting dialysis and no other comorbidity, except well-controlled hypertension and hyperparathyroidism requiring treatment with cinacalcet. Clinical examination is essentially normal except for truncal obesity with height 167 cm and weight 121 kg, giving her a body mass index of 43...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28977163/use-of-cinacalcet-and-sunitinib-to-treat-hypercalcaemia-due-to-a-pancreatic-neuroendocrine-tumor
#15
Hernan Valdes-Socin, Matilde Rubio Almanza, Mariana Tomé Fernández-Ladreda, Daniel Van Daele, Marc Polus, Marcela Chavez, Albert Beckers
Neuroendocrine tumors (NETs) can secrete hormones, including ectopic secretions, but they have been rarely associated with malignant hypercalcemia. A 52-year-old man with a history of diabetes mellitus was diagnosed with a pancreatic tumor. A pancreatic biopsy confirmed a well-differentiated pancreatic NET (pNET). The patient subsequently developed liver metastasis and hypercalcemia with high 1,25 OH vitamin D and suppressed parathyroid hormone (PTH) levels. Hypercalcemia was refractory to chemotherapy, intravenous saline fluids, diuretics, calcitonin and zoledronate...
September 18, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28872126/application-and-methodology-of-the-non-destructive-19f-time-domain-nmr-technique-to-measure-the-content-in-fluorine-containing-drug-products
#16
Maria Victoria Silva Elipe, Lan Li, Karthik Nagapudi, Alan M Kook, Carlos Cobas, Isaac Iglesias, Chen Peng
Here, we describe a protocol developed by our group that uses low-field fluorine-19 ((19)F) time-domain (TD) nuclear magnetic resonance (NMR) to measure the average content of fluorinated drugs in their formulated drug product forms: tablets or capsules. This method is specific to fluorinated drugs because it detects only the content of fluorine, avoiding interference from the excipients that lack fluorine. The advantages of measuring the active content of fluorinated drugs using low-field (19)F TD-NMR versus high-field (19)F solid-state (SS) NMR are the simplicity of the method; the low cost; and the non-destructive nature of the technique, with all samples recoverable in intact forms (e...
August 22, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28843775/parathyroid-hormone-contributes-to-the-down-regulation-of-cytochrome-p450-3a-through-the-camp-pi3k-pkc-pka-nf-%C3%AE%C2%BAb-signaling-pathway-in-secondary-hyperparathyroidism
#17
Hiroshi Watanabe, Ryusei Sugimoto, Komei Ikegami, Yuki Enoki, Tadashi Imafuku, Rui Fujimura, Jing Bi, Kento Nishida, Yoshiaki Sakaguchi, Michiya Murata, Hitoshi Maeda, Kenshiro Hirata, Sachiko Jingami, Yu Ishima, Motoko Tanaka, Kazutaka Matsushita, Hirotaka Komaba, Masafumi Fukagawa, Masaki Otagiri, Toru Maruyama
Chronic kidney disease (CKD), which affects, not only renal clearance, but also non-renal clearance, is accompanied by a decline in renal function. Although it has been suggested that humoral factors, such as uremic toxins that accumulate in the body under CKD conditions, could be involved in the changes associated with non-renal drug clearance, the overall process is not completely understood. In this study, we report on the role of parathyroid hormone (PTH), a middle molecule uremic toxin, on the expression of drug metabolizing or transporting proteins using rats with secondary hyperparathyroidism (SHPT) as models...
August 24, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28834128/plasma-parathyroid-hormone-and-cardiovascular-disease-in-treatment-naive-patients-with-primary-hyperparathyroidism-the-epath-trial
#18
Julia Wetzel, Stefan Pilz, Martin R Grübler, Astrid Fahrleitner-Pammer, Hans P Dimai, Dirk von Lewinski, Ewald Kolesnik, Sabine Perl, Christian Trummer, Verena Schwetz, Andreas Meinitzer, Evgeny Belyavskiy, Jakob Völkl, Cristiana Catena, Vincent Brandenburg, Winfried März, Burkert Pieske, Helmut Brussee, Andreas Tomaschitz, Nicolas D Verheyen
Patients with primary hyperparathyroidism are at increased risk for high blood pressure, vascular stiffening, and left ventricular hypertrophy, but previous studies have failed to demonstrate the direct associations with circulating parathyroid hormone (PTH) levels. The authors investigated cross-sectional relationships between PTH and 24-hour pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index in patients with primary hyperparathyroidism who were treatment-naive with cinacalcet, renin-angiotensin-aldosterone-system inhibitors, and thiazide or loop diuretics...
November 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28833550/cinacalcet-rectifies-hypercalcemia-in-a-patient-with-familial-hypocalciuric-hypercalcemia-type-2-fhh2-caused-by-a-germline-loss-of-function-g%C3%AE-11-mutation
#19
Caroline M Gorvin, Fadil M Hannan, Treena Cranston, Helena Valta, Outi Makitie, Camilla Schalin-Jantti, Rajesh V Thakker
G-protein subunit α-11 (Gα11 ) couples the calcium-sensing receptor (CaSR) to phospholipase C (PLC)-mediated intracellular calcium (Ca(2+)i ) and mitogen-activated protein kinase (MAPK) signaling, which in the parathyroid glands and kidneys regulates parathyroid hormone release and urinary calcium excretion, respectively. Heterozygous germline loss-of-function Gα11 mutations cause familial hypocalciuric hypercalcemia type 2 (FHH2), for which effective therapies are currently not available. Here, we report a novel heterozygous Gα11 germline mutation, Phe220Ser, which was associated with hypercalcemia in a family with FHH2...
August 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28803497/exploring-the-potential-value-of-improved-care-for-secondary-hyperparathyroidism-with-a-novel-calcimimetic-therapy
#20
Björn Stollenwerk, Sergio Iannazzo, Kerry Cooper, Vasily Belozeroff
AIMS: This study explored the use of a value-based pricing approach for the new calcimimetic etelcalcetide indicated for the treatment of secondary hyperparathyroidism (SHPT) in patients receiving hemodialysis. It used the US payer perspective and applied the cost-effectiveness framework. Because etelcalcetide is an intravenous therapy that can be titrated for individual patients, and because its utilization is yet to be assessed in real world settings, a range of plausible doses were estimated for etelcalcetide to define a range of prices...
August 14, 2017: Journal of Medical Economics
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