Long-term effect of cinacalcet hydrochloride on abdominal aortic calcification in patients on hemodialysis with secondary hyperparathyroidism

Kazunori Nakayama, Kazushi Nakao, Yuji Takatori, Junko Inoue, Shoichirou Kojo, Shigeru Akagi, Masaki Fukushima, Jun Wada, Hirofumi Makino

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Secondary hyperparathyroidism (SHPT) is one of the common complications in dialysis patients, and is associated with increased risk of vascular calcification. The effects of cinacalcet hydrochloride treatment on bone and mineral metabolism have been previously reported, but the benefit of cinacalcet on vascular calcification remains uncertain. The aim of this study was to evaluate the impact of cinacalcet on abdominal aortic calcification in dialysis patients. Subjects and methods: Patients were on maintenance hemodialysis with insufficiently controlled SHPT (intact parathyroid hormone [PTH].180 pg/mL) by conventional therapies. All subjects were initially administered 25 mg cinacalcet daily, with concomitant use of calcitriol analogs. Abdominal aortic calcification was annually evaluated by calculating aortic calcification area index (ACAI) using multidetector computed tomography (MDCT), from 12 months before to 36 months after the initiation of cinacalcet therapy. Results: Twenty-three patients were analyzed in this study. The mean age was 59.0±8.7 years, 34.8% were women, and the mean dialysis duration was 163.0±76.0 months. After administration of cinacalcet, serum levels of intact PTH, phosphorus, and calcium significantly decreased, and mean Ca × P values significantly decreased from 67.4±7.9 mg2/dL2 to 52±7.7 mg2/dL2. Although the ACAI value did not decrease during the observation period, the increase in ACAI between 24 months and 36 months after cinacalcet administration was significantly suppressed. Conclusion: Long-term administration of cinacalcet was associated with reduced progression of abdominal aortic calcification, and achieving appropriate calcium and phosphorus levels may reduce the rates of cardiovascular events and mortality in patients on hemodialysis.

Original languageEnglish
Pages (from-to)25-33
Number of pages9
JournalInternational Journal of Nephrology and Renovascular Disease
Volume7
DOIs
Publication statusPublished - Dec 18 2013

Fingerprint

Secondary Hyperparathyroidism
Renal Dialysis
Vascular Calcification
Dialysis
Parathyroid Hormone
Phosphorus
Calcium
Multidetector Computed Tomography
Cinacalcet Hydrochloride
Calcitriol
Minerals
Therapeutics
Maintenance
Observation
Bone and Bones
Mortality
Serum

Keywords

  • Abdominal aortic calcification
  • Cinacalcet hydrochloride
  • Hemodialysis

ASJC Scopus subject areas

  • Nephrology

Cite this

Long-term effect of cinacalcet hydrochloride on abdominal aortic calcification in patients on hemodialysis with secondary hyperparathyroidism. / Nakayama, Kazunori; Nakao, Kazushi; Takatori, Yuji; Inoue, Junko; Kojo, Shoichirou; Akagi, Shigeru; Fukushima, Masaki; Wada, Jun; Makino, Hirofumi.

In: International Journal of Nephrology and Renovascular Disease, Vol. 7, 18.12.2013, p. 25-33.

Research output: Contribution to journalArticle

Nakayama, Kazunori ; Nakao, Kazushi ; Takatori, Yuji ; Inoue, Junko ; Kojo, Shoichirou ; Akagi, Shigeru ; Fukushima, Masaki ; Wada, Jun ; Makino, Hirofumi. / Long-term effect of cinacalcet hydrochloride on abdominal aortic calcification in patients on hemodialysis with secondary hyperparathyroidism. In: International Journal of Nephrology and Renovascular Disease. 2013 ; Vol. 7. pp. 25-33.
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T1 - Long-term effect of cinacalcet hydrochloride on abdominal aortic calcification in patients on hemodialysis with secondary hyperparathyroidism

AU - Nakayama, Kazunori

AU - Nakao, Kazushi

AU - Takatori, Yuji

AU - Inoue, Junko

AU - Kojo, Shoichirou

AU - Akagi, Shigeru

AU - Fukushima, Masaki

AU - Wada, Jun

AU - Makino, Hirofumi

PY - 2013/12/18

Y1 - 2013/12/18

N2 - Background: Secondary hyperparathyroidism (SHPT) is one of the common complications in dialysis patients, and is associated with increased risk of vascular calcification. The effects of cinacalcet hydrochloride treatment on bone and mineral metabolism have been previously reported, but the benefit of cinacalcet on vascular calcification remains uncertain. The aim of this study was to evaluate the impact of cinacalcet on abdominal aortic calcification in dialysis patients. Subjects and methods: Patients were on maintenance hemodialysis with insufficiently controlled SHPT (intact parathyroid hormone [PTH].180 pg/mL) by conventional therapies. All subjects were initially administered 25 mg cinacalcet daily, with concomitant use of calcitriol analogs. Abdominal aortic calcification was annually evaluated by calculating aortic calcification area index (ACAI) using multidetector computed tomography (MDCT), from 12 months before to 36 months after the initiation of cinacalcet therapy. Results: Twenty-three patients were analyzed in this study. The mean age was 59.0±8.7 years, 34.8% were women, and the mean dialysis duration was 163.0±76.0 months. After administration of cinacalcet, serum levels of intact PTH, phosphorus, and calcium significantly decreased, and mean Ca × P values significantly decreased from 67.4±7.9 mg2/dL2 to 52±7.7 mg2/dL2. Although the ACAI value did not decrease during the observation period, the increase in ACAI between 24 months and 36 months after cinacalcet administration was significantly suppressed. Conclusion: Long-term administration of cinacalcet was associated with reduced progression of abdominal aortic calcification, and achieving appropriate calcium and phosphorus levels may reduce the rates of cardiovascular events and mortality in patients on hemodialysis.

AB - Background: Secondary hyperparathyroidism (SHPT) is one of the common complications in dialysis patients, and is associated with increased risk of vascular calcification. The effects of cinacalcet hydrochloride treatment on bone and mineral metabolism have been previously reported, but the benefit of cinacalcet on vascular calcification remains uncertain. The aim of this study was to evaluate the impact of cinacalcet on abdominal aortic calcification in dialysis patients. Subjects and methods: Patients were on maintenance hemodialysis with insufficiently controlled SHPT (intact parathyroid hormone [PTH].180 pg/mL) by conventional therapies. All subjects were initially administered 25 mg cinacalcet daily, with concomitant use of calcitriol analogs. Abdominal aortic calcification was annually evaluated by calculating aortic calcification area index (ACAI) using multidetector computed tomography (MDCT), from 12 months before to 36 months after the initiation of cinacalcet therapy. Results: Twenty-three patients were analyzed in this study. The mean age was 59.0±8.7 years, 34.8% were women, and the mean dialysis duration was 163.0±76.0 months. After administration of cinacalcet, serum levels of intact PTH, phosphorus, and calcium significantly decreased, and mean Ca × P values significantly decreased from 67.4±7.9 mg2/dL2 to 52±7.7 mg2/dL2. Although the ACAI value did not decrease during the observation period, the increase in ACAI between 24 months and 36 months after cinacalcet administration was significantly suppressed. Conclusion: Long-term administration of cinacalcet was associated with reduced progression of abdominal aortic calcification, and achieving appropriate calcium and phosphorus levels may reduce the rates of cardiovascular events and mortality in patients on hemodialysis.

KW - Abdominal aortic calcification

KW - Cinacalcet hydrochloride

KW - Hemodialysis

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