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Motoko Tanaka, Kazuki Yoshida, Shingo Fukuma, Kazuko Ito, Kazutaka Matsushita, Masafumi Fukagawa, Shunichi Fukuhara, Tadao Akizawa
OBJECTIVES: Anemia is an important prognostic factor in hemodialysis patients. It has been reported that parathyroidectomy ameliorates anemia and reduces the requirement of postoperative erythropoiesis-stimulating agents. The objective of this study was to assess the effect of cinacalcet, which is considered as a pharmacological parathyroidectomy, on anemia in hemodialysis patients. METHODS: We used data from a prospective cohort of Japanese hemodialysis patients with secondary hyperparathyroidism; the criteria were: intact parathyroid hormone concentrations ≥ 180 pg/mL or use of an intravenous or oral vitamin D receptor activator...
2016: PloS One
Evelyne Rey, Claude-Emilie Jacob, Maral Koolian, Francine Morin
Hypercalcemia in pregnancy is an uncommon event that can cause major maternal morbidity and/or fetal or neonatal morbidity and mortality. Management is a challenge for the clinicians, especially as regards to investigations in pregnancy, surgery, and the use of cinacalcet and bisphosphonates. We present three case reports and discuss management.
October 2016: Clinical Case Reports
Guillaume Jean, Jean-Claude Souberbielle, Eric Zaoui, Christie Lorriaux, Jean-Marc Hurot, Brice Mayor, Patrik Deleaval, Manolie Mehdi, Charles Chazot
BACKGROUND: Observational studies have recently associated a decrease in serum parathyroid hormone (PTH) level with a higher rate of mortality among hemodialysis (HD) patients. Decreases in PTH level can result from medical intervention (MPD) and surgical parathyroidectomy (PTX), or may occur spontaneously, usually associated with an underlying malnutrition-inflammation syndrome (SPD). The aim of our study was to prospectively identify the incidence of decreases in PTH level in a cohort of HD patients and the frequency distribution of the different causes (MPD, PTX and SPD), as well as to evaluate the survival outcomes for each PTH group (MPD, PTX and SPD) compared to patients who did not experience a PTH decrease over the first 36 months of the study (NPD)...
October 18, 2016: BMC Nephrology
Alicja E Grzegorzewska, Mateusz Paciorkowski, Adrianna Mostowska, Bartosz Frycz, Wojciech Warchoł, Ireneusz Stolarek, Marek Figlerowicz, Paweł P Jagodziński
Nephrolithiasis, secondary hyperparathyroidism (sHPT), and cardiovascular complications are associated with disturbances in Ca handling and contribute to morbidity/mortality during haemodialysis (HD). Calcimimetics, activators of the calcium-sensing receptor (CaSR), provide an effective means of reducing parathyroid hormone (PTH) secretion in sHPT. Polymorphism in CaSR gene (CASR) influences Ca-related parameters, however it was not shown in HD patients for CASR rs7652589. The minor allele at this polymorphism modifies the binding sites of transcription factors and CaSR expression...
October 14, 2016: Scientific Reports
Yanchen Zhang, Kristin M Corapi, Maria Luongo, Ravi Thadhani, Sagar U Nigwekar
BACKGROUND: Calciphylaxis is a rare but devastating condition in end-stage renal disease (ESRD) patients. Most research in the field of calciphylaxis is focused on hemodialysis (HD) patients; however, data on calciphylaxis incidence, risk factors, and mortality in peritoneal dialysis (PD) patients are limited. METHODS: In this cohort study, we examined data from adult patients who initiated PD for ESRD management at our institute's PD unit from January 2001 to December 2015...
2016: International Journal of Nephrology and Renovascular Disease
Wouter P Kluijfhout, Wessel M C M Vorselaars, Sandra A M van den Berk, Menno R Vriens, Inne H M Borel Rinkes, Gerlof D Valk, Thijs van Dalen, John M H de Klerk, Bart de Keizer
BACKGROUND: Several reports have shown good performance of fluorine-18 fluorocholine (F-FCH) PET-computed tomography (CT) for parathyroid localization, although overall evidence remains scarce. We collected data from three institutions in the Netherlands and investigated the performance of F-FCH PET-CT as a second-line imaging modality. MATERIALS AND METHODS: We performed a retrospective review of all patients at least 18 years who underwent F-FCH PET-CT for biochemically proven hyperparathyroidism (HPT) and inconclusive ultrasound and sestamibi scintigraphy...
September 8, 2016: Nuclear Medicine Communications
Min Wu, Ri-Ning Tang, Hong Liu, Ming-Ming Pan, Bi-Cheng Liu
AIM: Experimental studies found that cinacalcet (CINA) markedly attenuated vascular calcification in uremic rats, but its underlying mechanisms are still largely unknown. Recent evidence have demonstrated that endothelial cells (ECs) participate in ectopic calcification in part by mediating endothelial-to-mesenchymal transition (EndMT). In this study, we investigated whether CINA ameliorated aortic calcification in uremic rats via suppression of EndMT. METHODS: Uremia was induced in rats by feeding rats a 0...
September 5, 2016: Acta Pharmacologica Sinica
Ariadna Pérez-Ricart, Maria Galicia-Basart, Maria Alcalde-Rodrigo, Alfons Segarra-Medrano, Josep-Maria Suñé-Negre, José-Bruno Montoro-Ronsano
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted...
2016: PloS One
A Schattner, I Dubin, R Huber, M Gelber
BACKGROUND: Hypercalcaemia of malignancy is well recognised, but hypocalcaemia in cancer patients is not, although it is increasingly encountered. METHODS: Analysis of an exemplary case and a narrative review of the literature based on the search terms cancer and hypocalcaemia. RESULTS: Hypocalcaemia may affect as many as 10% of hospitalised cancer patients. We identified 12 different potential mechanisms of hypocalcaemia of malignancy. Identifying the pathogenesis is essential for the correct treatment and can usually be performed at the bedside, based on serum parathyroid hormone (PTH) levels, creatinine, phosphate, magnesium, creatine kinase, liver enzymes and 25(OH)D...
July 2016: Netherlands Journal of Medicine
Pia Villarroel, Pamela Mattar, Amanda D'Espessailles, Marco Arrese, Andrea Arreguin, Cecilia Fuentes, Marcela Reyes, Mariana Cifuentes
The calcium sensing receptor (CaSR) is expressed in human adipose cells, and its activation may associate with adipose tissue (AT) dysfunction. We evaluated whether CaSR stimulation influences adipocyte triglyceride (TG) and fatty acid binding protein 4 (aP2) content, and hepatocyte TGs and proinflammatory cytokine expression. The effect of the calcimimetic cinacalcet on TGs (fluorimetry), lipogenic genes (qPCR) and aP2 (immunoblot) was evaluated in LS14 adipocytes or AT. In the human HepG2 hepatic cell line, we assessed CaSR expression and cinacalcet effect on TGs and lipogenic and proinflammatory genes...
October 1, 2016: Archives of Biochemistry and Biophysics
Peggy Perrin, Clotilde Kiener, Rose-Marie Javier, Laura Braun, Noelle Cognard, Gabriela Gautier-Vargas, Francoise Heibel, Clotilde Muller, Jerome Olagne, Bruno Moulin, Sophie Caillard
BACKGROUND: The management of chronic kidney disease-mineral and bone disorders (CKD-MBD) has recently changed. We investigated the modifications of CKD-MBD with a special focus on the incidence of fractures in the first year after kidney transplantation (KT). METHODS: We retrospectively compared 2 groups of patients who consecutively underwent transplantation at our center 5 years from each other. Group 1 consisted of patients (n=152) transplanted between 2004 and 2006, whereas patients in group 2 (n=137) underwent KT between 2009 and 2011...
August 19, 2016: Transplantation
Corrado Vitale, Francesca Bermond, Amelia Rodofili, Giorgio Soragna, Cristina Marcuccio, Alberto Tricerri, Martino Marangella
Primary hyperparathyroidism (PHPT) may favor nephrolithiasis mainly through an increase in calcium and phosphate urinary excretion. Cinacalcet exhibits good efficacy to control hypercalcemia in PHPT, but it is not so far known whether it might be a useful tool to prevent stone recurrences. Of 67 patients with PHPT and recurrent nephrolithiasis, 55 underwent parathyroidectomy (PTX) and 12, not eligible to PTX, were prescribed Cinacalcet. All the patients were evaluated for mineral metabolism, including estimation of state of saturation for calcium oxalate (CaOx) and brushite (bsh), both at baseline and after either PTX or Cinacalcet...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Teresa Dryl-Rydzyńska, Tomasz Prystacki, Wojciech Marcinkowski
Secondary hyperparathyroidism (sHPT) is a common complication being a consequence of metabolic disorders associated with chronic kidney disease (CKD). Treatment of the sHPT should lead to calcium-phosphate management stabilization and parathyroid hormone levels reduction. The phosphate binders, synthetic vitamin D analogs and calcimimetics are used in sHPT treatment. In this paper we analyzed the results of three month paricalcitol treatment of 36 hemodialysis patients with sHPT (serum iPTH> 500 pg/ml). 11 patients have additionally received cinacalcet...
2016: Przegla̧d Lekarski
Priyesh Chauhan, Neil J Gittoes, Tarekegn Geberhiwot
A man aged 72 years with long-standing primary hyperparathyroidism (HPT), a background of recurrent bilateral renal stones and failed parathyroid surgery is described. During the 27 months preceding treatment, episodes of renal colic became increasingly frequent and he required multiple surgical interventions. Given the lack of medical therapies to definitively treat his symptoms, he was started on a trial of the calcimimetic, Cinacalcet. Cinacalcet has previously been shown to reduce hypercalcaemia in patients with primary HPT...
2016: BMJ Case Reports
Takeshi Sato, Koji Muroya, Junko Hanakawa, Sumimasa Yamashita, Kumiko Nozawa, Katsuhiko Masudo, Tadashi Yamakawa, Yumi Asakura, Tomonobu Hasegawa, Masanori Adachi
We report a Japanese pedigree with familial primary hyperparathyroidism due to a CDC73 mutation. To our knowledge, this is the first report of cinacalcet as a treatment for CDC73-related primary hyperparathyroidism. The proband had severe psychomotor retardation and received laryngotracheal separation surgery. At 19 yr of age, he developed acute pancreatitis. Hypercalcemia (12.2-13.8 mg/dL), elevated levels of intact PTH (86-160 pg/mL), and a tumor detected upon neck ultrasonography led to the diagnosis of primary hyperparathyroidism...
July 2016: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
Thomas Welte, Frederic Arnold, Kristin Technau-Hafsi, Elke Neumann-Haefelin, Rika Wobser, Stefan Zschiedrich, Gerd Walz, Albrecht Kramer-Zucker
UNLABELLED: Calciphylaxis is a rare and often fatal condition mostly associated with end-stage renal disease. The pathophysiology remains elusive and treatment options are scarce. We present a rare case of severe calciphylaxis after kidney transplantation in a patient with persistent hyperparathyroidism. CASE DESCRIPTION: A 78-year-old man with a history of end-stage renal disease developed edema and ulcerations on both lower limbs 14 months after kidney transplantation while receiving an mammalian target of rapamycin inhibitor to manage polyoma virus-associated nephropathy...
April 2016: Transplantation Direct
E Ważna-Jabłońska, Z Gałązka, M Durlik
INTRODUCTION: Hypercalcemia caused by persistent hyperparathyroidism after successful kidney transplantation (KT) is a common problem and may negatively affect graft function, bone metabolism and the cardiovascular system. Cinacalcet is a novel, available tool to control hypercalcemia after KT. The aim of the study was to examine the efficacy of cinacalcet in lowering calcium in KT recipients with persistent hypercalcemia owing to hyperparathyroidism. METHODS: In this retrospective observational study, we analyzed 30 patients with persistent hypercalcemia >10...
June 2016: Transplantation Proceedings
Sohyun Jeong, In-Wha Kim, Kook-Hwan Oh, Nayoung Han, Kwon Wook Joo, Hyo Jin Kim, Jung Mi Oh
BACKGROUND: Secondary hyperparathyroidism (SHPT) is one of the major risk factors of morbidity and mortality in end-stage renal disease. Cinacalcet effectively controls SHPT without causing hypercalcemia and hyperphosphatemia. However, there is significant inter-individual response variance to cinacalcet treatment. Therefore, we aimed to evaluate the genetic effects related with parathyroid hormone regulation as factors for cinacalcet response variance. METHODS: Patients with a diagnosis of SHPT based on intact parathyroid hormone (iPTH) >300 pg/mL on dialysis were included in this study...
2016: Drug Design, Development and Therapy
Antonio Bellasi, Mario Cozzolino, Domenico Russo, Donald Molony, Biagio Di Iorio
AIMS: Whether differences in outcomes of calcium-free vs. calcium-containing phosphate binder treatments can be amplified by concurrent treatment with a calcium-sensing receptor agonist or vitamin D remains to be elucidated. MATERIAL AND METHODS: A post-hoc analysis of the INDEPENDENT study, an open-label randomized controlled trial designed to evaluate the impact of sevelamer (SV) vs. calcium salts (CS) on survival in incident dialysis patients. RESULTS: We recruited 466 middle-aged men and women...
September 2016: Clinical Nephrology
Carlo Vulpio, Maurizio Bossola
In secondary hyperparathyroidism (SHPT), ultrasonography (US) can accurately define the size and structure of parathyroid glands as well as differentiate diffuse and nodular hyperplasia. US may be also useful to predict the response of SHPT to vitamin D analogs and cinacalcet and to assess for regression of parathyroid glands hyperplasia by measurement of parathyroid gland volume. There is increasing evidence that US can potentially identify patients who will benefit from prompt surgical intervention. Therefore, US should be part of the diagnostic armamentarium in the treatment of SHPT in the daily clinical practice...
September 2016: Seminars in Dialysis
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