Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients

Introduction: Secondary hyperparathyroidism (SHPT) is one of the components of chronic kidney disease–mineral bone disorder (CKD-MBD) with significant contribution to the morbidity and mortality among prevalent hemodialysis (HD) patients. Objectives: This multi-centric experience study aims to compa...

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Autores principales:	Maha A. Behairy, Osama Mahmoud, Ayman Rabie Ibrahim, Aber H. Baki
Formato:	article
Lenguaje:	EN
Publicado:	Society of Diabetic Nephropathy Prevention 2022
Materias:	secondary hyperparathyroidism alfacalcidol cinacalcet paricalcitol Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/8a4ebf413edf4aa9a895d6a4a4301004
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spelling	oai:doaj.org-article:8a4ebf413edf4aa9a895d6a4a43010042021-11-17T08:15:00ZComparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients2345-420210.34172/npj.2022.05https://doaj.org/article/8a4ebf413edf4aa9a895d6a4a43010042022-01-01T00:00:00Zhttps://jnephropharmacology.com/PDF/npj-10378https://doaj.org/toc/2345-4202Introduction: Secondary hyperparathyroidism (SHPT) is one of the components of chronic kidney disease–mineral bone disorder (CKD-MBD) with significant contribution to the morbidity and mortality among prevalent hemodialysis (HD) patients. Objectives: This multi-centric experience study aims to compare the effectiveness of intravenous (IV) paricalcitol versus oral cinacalcet and oral cinacalcet plus oral alfacalcidol as treatment regimens of SHPT among chronic HD patients. Patients and Methods: This is a retrospective observational cohort study, in which 130 prevalent HD patients with SHPT was recruited from three main HD centres of Aljouf region in Saudi Arabia. Patients were divided into three groups; group I (50) HD patients were treated by IV paricalcitol, group II (50) HD patients who received oral cinacalcet plus oral alfacalcidol, group III (30) HD patients were on oral cinacalcet. Serum intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (Po4) and alkaline phosphatase (ALP) tests were assessed at 0, 3, 6, and 9 months. Results: A total of 130 (61 (47%) females, (53%) 69 males) HD patients with mean age 56.30 ± 19.1 years, and with mean HD duration of 4.86±4.15 years were enrolled in the study. The mean of iPTH is significantly reduced in all studied groups (P<0.001). Mean Δchanges in iPTH concentration in groups I, II, III were -242.11±148.75, -225.54±153.91 and -254.83±275.17 respectively; P>0.05) with statistical non-significant differences. Increase of Ca×Po4 with paricalcitol group as mean ΔChange in (Ca×PO4) was in the groups I, II, III (15.39±9.46, 1.97±11.74, -2.89±9.37) respectively (P<0.001). Our study showed a significant increase in serum phosphorus from the baseline in patients of group II. Conclusion: IV paricalcitol based regimen assumed to be equally effective in suppressing SHPT in HD patients when compared to the combination of oral cinacalcet with oral alfacalcidol or treatment with oral cinacalcet alone.Maha A. BehairyOsama MahmoudAyman Rabie IbrahimAber H. BakiSociety of Diabetic Nephropathy Prevention articlesecondary hyperparathyroidismalfacalcidolcinacalcetparicalcitolTherapeutics. PharmacologyRM1-950Diseases of the genitourinary system. UrologyRC870-923ENJournal of Nephropharmacology, Vol 11, Iss 1, Pp e5-e5 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	secondary hyperparathyroidism alfacalcidol cinacalcet paricalcitol Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923
spellingShingle	secondary hyperparathyroidism alfacalcidol cinacalcet paricalcitol Therapeutics. Pharmacology RM1-950 Diseases of the genitourinary system. Urology RC870-923 Maha A. Behairy Osama Mahmoud Ayman Rabie Ibrahim Aber H. Baki Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
description	Introduction: Secondary hyperparathyroidism (SHPT) is one of the components of chronic kidney disease–mineral bone disorder (CKD-MBD) with significant contribution to the morbidity and mortality among prevalent hemodialysis (HD) patients. Objectives: This multi-centric experience study aims to compare the effectiveness of intravenous (IV) paricalcitol versus oral cinacalcet and oral cinacalcet plus oral alfacalcidol as treatment regimens of SHPT among chronic HD patients. Patients and Methods: This is a retrospective observational cohort study, in which 130 prevalent HD patients with SHPT was recruited from three main HD centres of Aljouf region in Saudi Arabia. Patients were divided into three groups; group I (50) HD patients were treated by IV paricalcitol, group II (50) HD patients who received oral cinacalcet plus oral alfacalcidol, group III (30) HD patients were on oral cinacalcet. Serum intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (Po4) and alkaline phosphatase (ALP) tests were assessed at 0, 3, 6, and 9 months. Results: A total of 130 (61 (47%) females, (53%) 69 males) HD patients with mean age 56.30 ± 19.1 years, and with mean HD duration of 4.86±4.15 years were enrolled in the study. The mean of iPTH is significantly reduced in all studied groups (P<0.001). Mean Δchanges in iPTH concentration in groups I, II, III were -242.11±148.75, -225.54±153.91 and -254.83±275.17 respectively; P>0.05) with statistical non-significant differences. Increase of Ca×Po4 with paricalcitol group as mean ΔChange in (Ca×PO4) was in the groups I, II, III (15.39±9.46, 1.97±11.74, -2.89±9.37) respectively (P<0.001). Our study showed a significant increase in serum phosphorus from the baseline in patients of group II. Conclusion: IV paricalcitol based regimen assumed to be equally effective in suppressing SHPT in HD patients when compared to the combination of oral cinacalcet with oral alfacalcidol or treatment with oral cinacalcet alone.
format	article
author	Maha A. Behairy Osama Mahmoud Ayman Rabie Ibrahim Aber H. Baki
author_facet	Maha A. Behairy Osama Mahmoud Ayman Rabie Ibrahim Aber H. Baki
author_sort	Maha A. Behairy
title	Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
title_short	Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
title_full	Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
title_fullStr	Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
title_full_unstemmed	Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
title_sort	comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
publisher	Society of Diabetic Nephropathy Prevention
publishDate	2022
url	https://doaj.org/article/8a4ebf413edf4aa9a895d6a4a4301004
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Comparison between paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients

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