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Peritoneal dialysis cinacalcet

Carlo Crepaldi, Alessandro Possidoni, Flavia Caputo, Roberto Dell'Aquila, Emilio Giulio Galli, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Roberto Russo
Background: In Italy, few studies have examined the clinical management of peritoneal dialysis (PD) patients, resulting in a lack of information and awareness. Methods: A total of 378 PD patients (64.7 ± 14.3 years, 58.9% males) were enrolled across 15 centres in a 12-month retrospective and 6-month prospective study. The primary objective was to evaluate the achievement of Kidney Disease Outcomes Quality Initiative and Kidney Disease Improving Global Outcomes guidelines on recommended target values for anaemia, high blood pressure and mineral metabolism...
April 2018: Clinical Kidney Journal
Luigi Cirillo, Pamela Gallo, Carmela Errichiello, Annasara Sorrentino, Alma Mehmetaj, Marco Gregori, Rossella Cannavò, Giuseppe Cestone, Roberta Cutruzzulà, Pietro Claudio Dattolo
Disorders of calcium-phosphate-parathormone balance, are very important issues in ESRD patients, that may lead to severe complications, as dystrophic calcinosis cutis, a rare disease, caused by calcium salt deposits in cutaneous or subcutaneous tissues and many organs. We present the case of a 47 years old woman, in ESRD due to membranous glomerulopathy, treated by peritoneal dialysis, who, after 7 months of dialysis, developed painful masses on second finger and fifth metacarpus of the right hand. Laboratory and instrumental data showed hyperparathyroidism with a parathyroid mass consistent with adenoma...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Sara Querido Conde, Patrícia Branco, Henrique Sousa, Teresa Adragão, Augusta Gaspar, José Diogo Barata
INTRODUCTION: Secondary hyperparathyroidism is the target of several therapeutic strategies, including the use of cinacalcet. Most studies were done only in hemodialysis patients, with few data from peritoneal dialysis patients. OBJECTIVE: The aim of our work was to evaluate the effectiveness of cinacalcet in secondary hyperparathyroidism in a one-center peritoneal dialysis patients. METHODS: A retrospective study was performed in 27 peritoneal dialysis patients with moderate to severe secondary hyperparathyroidism (PTHi > 500 pg/mL with normal or elevated serum calcium levels) treated with cinacalcet...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Wolfgang Pronai, Alexander R Rosenkranz, Andreas Bock, Renate Klauser-Braun, Christine Jäger, Gunther Pendl, Margit Hemetsberger, Karl Lhotta
Secondary hyperparathyroidism is a complex disorder requiring an individualized multicomponent treatment approach. This study was conducted to identify treatment combinations used in clinical practice in Austria and Switzerland and the potential to control this disorder. A total of 333 adult hemodialysis and peritoneal dialysis patients were analyzed. All patients received conventional care prior to initiation of a cinacalcet-based regimen. During the study, treatment components, e.g. cinacalcet, active vitamin D analogues and phosphate binders, were adapted to individual patient requirements and treatment dynamics were documented...
May 2017: Wiener Klinische Wochenschrift
Shunsuke Yamada, Kazuhiko Tsuruya, Masanori Tokumoto, Hisako Yoshida, Narihito Tatsumoto, Hiroaki Ooboshi, Takanari Kitazono
As fibroblast growth factor 23 (FGF23) has been shown to induce cardiovascular disease directly in patients with chronic kidney disease, identification of factors and treatments that can modulate serum FGF23 (sFGF23) level is clinically important. This retrospective longitudinal study investigated factors that modulate sFGF23 in 49 patients who underwent peritoneal dialysis (PD). sFGF23 ratio (sFGF23 at 18 months/baseline sFGF23) was used as an indicator of changes in sFGF23 level. Total phosphate elimination was the sum of both renal phosphate excretion and dialysate phosphate elimination...
February 2017: Therapeutic Apheresis and Dialysis
Kristine Lindhard, Bo Broberg, Henrik Groenberg, Henrik Post Hansen
Chronic Kidney Disease patients suffer from Mineral and Bone Disorder (CKD-MBD) leading to increased vascular and soft-tissue calcification. The prevalence of soft tissue calcification in dialysis patients is not well described, and most cases describe such calcifications in hemodialysis patients. We describe a case of a massive soft tissue calcification in the right gluteal region in a peritoneal dialysis patient. The patient had severe pain and were disabled. The treatment was converted to an intensive hemodialysis regimen with a minimal calcium load and high dose of cinacalcet...
April 2017: Hemodialysis International
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
James Goya Heaf
PURPOSE: The purpose of this paper was to review the literature concerning the treatment of chronic kidney disease-mineral bone disorder (CKD-MBD) in the elderly peritoneal dialysis (PD) patient. RESULTS: Chronic kidney disease-mineral bone disorder is a major problem in the elderly PD patient, with its associated increased fracture risk, vascular calcification, and accelerated mortality fracture risk. Peritoneal dialysis, however, bears a lower risk than hemodialysis (HD)...
November 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Roberta Russo, Gennaro Argentino, Immacolata Daniela Maresca, Giuseppina Sannino, Andrea Memoli, Bruno Memoli
Secondary Hyperparathyroidism is an important concurrent cause of cardiovascular and osteo-articular events, as well as, high morbidity and mortality for patients suffering from chronic kidney disease in conservative therapy and dialysis. The usual therapies, such as the vitamin D active metabolites and the phosphate binders did not always demonstrate effective in SHP control. New drugs, such as the calcimimetics, are available, resulting beneficial in highly reducing PTH levels. The only calcimimetic drug clinically used is cinacalcet, whose use is planned only in patients undergoing dialysis (peritoneal and extracorporeal)...
July 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Ramón Alberto Tamayo-Isla, Mauro Cuba de la Cruz
INTRODUCTION: Calciphylaxis is a rare medical condition that is usually diagnosed in patients suffering from end-stage renal disease who are already receiving renal replacement therapy and in those post-transplantation. The pathogenesis still remains to be fully elucidated; hence, the treatment is not uniform. The prognosis is generally poor. The ulcerative stage exhibits a worse prognosis than the nonulcerative one. Calciphylaxis presenting in terminal kidney disease prior to dialytic treatment has only rarely been reported...
2015: International Journal of Nephrology and Renovascular Disease
Abdulla A Alharthi, Naglaa M Kamal, Mohamed W Abukhatwah, Laila M Sherief
Cinacalcet, a calcimimetic drug, has been shown to be efficacious in adult chronic kidney disease (CKD) patients; however, it was not fully studied in pediatric CKD patients. We aimed at assessing the effect of cinacalcet on intact parathyroid hormone (iPTH) secretion in children with CKD-4/5 with iPTH consistently ≥ 300 pg/mL refractory to conventional treatment. This is a prospective cohort analysis of 28 children with uncontrolled hyper-parathyroidism secondary to stage 4 and 5 CKD admitted to a tertiary center during the period from April 2012 to April 2014...
January 2015: Medicine (Baltimore)
Kristen R Nichols, Chad A Knoderer, Bethanne Johnston, Amy C Wilson
A 2-year-old male with chronic kidney disease with secondary hyperparathyroidism developed hypercalcemia while receiving calcitriol, without achieving a serum parathyroid hormone concentration within the goal range. Cinacalcet 15 mg (1.2 mg/kg), crushed and administered via gastrostomy tube, was added to the patient's therapy. This therapy was effective in achieving targeted laboratory parameters in our patient despite instructions in the prescribing information that cinacalcet should always be taken whole.
July 2014: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Emmanuelle Laurain, Carole Ayav, Marie-Line Erpelding, Michèle Kessler, Serge Briançon, Laurent Brunaud, Luc Frimat
BACKGROUND: Recommendations for secondary hyperparathyroidism (SHPT) consider that a "one-size-fits-all" target enables efficacy of care. In routine clinical practice, SHPT continues to pose diagnosis and treatment challenges. One hypothesis that could explain these difficulties is that dialysis population with SHPT is not homogeneous. METHODS: EPHEYL is a prospective, multicenter, pharmacoepidemiological study including chronic dialysis patients (≥ 3 months) with newly SHPT diagnosis, i...
2014: BMC Nephrology
Lisa Borges, Pedro Rosa, Emanuel Dias, Isabel Cássio
A 48-year-old woman performing peritoneal dialysis for end-stage renal disease presented with a painful leg ulcer. The investigation revealed an elevated parathyroid hormone level and the histological examination of the biopsy tissue from the ulcer revealed medial calcification of the arterioles, consistent with calciphylaxis. The patient developed additional ulcers in the lower limbs and treatment with antibiotics, cinacalcet, sevelamer, sodium thiosulfate, low calcium dialysate and hyperbaric oxygen therapy was instituted...
2014: BMJ Case Reports
Kai Ming Chow, Cheuk Chun Szeto, Bonnie Ching-Ha Kwan, Phyllis Mei-Shan Cheng, Wing Fai Pang, Chi Bon Leung, Philip Kam-Tao Li
AIM: Although calcimimetics cinacalcet can reduce parathyroid hormone level and control secondary hyperparathyroidism in end-stage renal disease patients, risk of vascular calcification remains high. Whether cinacalcet can further reduce vascular damage or arterial stiffness is unknown. METHODS: We studied the effect of cinacalcet in 33 peritoneal dialysis patients with inadequately controlled secondary hyperparathyroidism despite standard treatment. The primary outcome was the aortic pulse wave velocity at 26 and 52 months after cinacalcet treatment...
June 2014: Nephrology
Trish Carter, Shobha Ratnam
Calciphylaxis is a rare and potentially devastating condition also referred to as uremic gangrene syndrome, calcific uremic arteriolopathy, metastatic calcification, and uremic small-vessel disease that can present in patients with end stage renal disease. This article reports a case of a 38-year-old African-American female on peritoneal dialysis for six years with a known history of non-adherence with diet, medications, and prescribed peritoneal dialysis treatment regimen. At her monthly clinic visit, the patient complained of burning sensation in the fingers of both hands with limited fine motor movement due to edema and severe pain...
September 2013: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Hyo Jin Kim, Hyunsuk Kim, Nara Shin, Ki Young Na, Yong Lim Kim, Daejung Kim, Jae Hyun Chang, Young Rim Song, Young-Hwan Hwang, Yon Su Kim, Curie Ahn, Joongyub Lee, Kook-Hwan Oh
BACKGROUND: Elevated serum level of fibroblast growth factor-23 (FGF23) is associated with adverse outcomes in dialyzed patients. OBJECTIVES: The CUPID study compared the efficacy of a cinacalcet-based regimen with conventional care (vitamin D and P binders) for achieving the stringent NKF-K/DOQI targets for peritoneal dialysis (PD) patients. Additionally, we analyzed change in FGF23 levels between two treatments to explore the cinacalcet effect in lowering FGF23...
May 25, 2013: BMC Nephrology
John Dotis, Nikoleta Printza, Chrisa Ghogha, Fotios Papachristou
BACKGROUND: Secondary hyperparathyroidism (HPT) constitute a high-turnover bone disease, manifested by elevated parathyroid hormone. Cinacalcet, belonging to calcimimetics, has been shown to be promising in the control of secondary HPT with limited data in children. OBJECTIVE: To evaluate the safety and efficacy of cinacalcet in children on peritoneal dialysis (PD) with secondary HPT. METHODS: Four patients on PD with severe secondary HPT, uncontrolled with phosphorus dietary restrictions combined with phosphate binders and analog of 1,25 vitamin D3 received cinacalcet...
2013: Journal of Pediatric Endocrinology & Metabolism: JPEM
J Emilio Sánchez-Álvarez, Carmen Rodríguez-Suárez, Diego Coronel-Aguilar, Isabel González-Díaz, Miguel Núñez-Moral, Beatriz Peláez-Requejo, Ana Fernández-Viña, Aurora Quintana-Fernández
INTRODUCTION: Paricalcitol, a selective activator of Vitamin D receptors, is successfully used as a treatment of hyperparathyroidism secondary to chronic kidney disease (CKD). In addition, it has been proposed for reducing proteinuria in patients with CKD. Nonetheless, little is known about its effect on peritoneal protein loss in patients on peritoneal dialysis (PD). OBJECTIVES: To analyse the efficiency of oral paricalcitol in secondary hyperparathyroidism control in PD patients and to verify its effect on urinary and peritoneal effluent protein loss...
January 18, 2013: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Steven M Brunelli, Keri L Monda, John M Burkart, Matthew Gitlin, Peter J Neumann, Grace S Park, Margarita Symonian-Silver, Susan Yue, Brian D Bradbury, Robert J Rubin
BACKGROUND: Launched in January 2011, the prospective payment system (PPS) for the US Medicare End-Stage Renal Disease Program bundled payment for services previously reimbursed independently. Small dialysis organizations may be particularly susceptible to the financial implications of the PPS. The ongoing Study to Evaluate the Prospective Payment System Impact on Small Dialysis Organizations (STEPPS) was designed to describe trends in care and outcomes over the period of PPS implementation...
June 2013: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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