Impact of Vitamin D Dose on Biochemical Parameters in Patients with Secondary Hyperparathyroidism Receiving Cinacalcet

• Type: Article in International Scientific Journal
• Date: 2009

Authors

Wilkie, M (Author) Other; Pontoriero, G (Author) Other; Macario, F (Author) Other; Yaqoob, M (Author) Other; Bouman, K (Author) Other; Braun, J (Author) Other; von Albertini, B (Author) Other; Brink, H (Author) Other; Maduell, F (Author) Other; Graf, H (Author) Other; João Frazão (Author) FMUP; Bos, WJ (Author) Other; Torregrosa, V (Author) Other; Saha, H (Author) Other; Reichel, H (Author) Other; Zani, VJ (Author) Other; Carter, D (Author) Other; Messa, P (Author) Other

Journal

Title: Nephron - Clinical Practice

Vol. 112

Pages: C41-C50

ISSN: 1660-2110

Publisher: S. Karger AG

Indexing

ISI Web of Knowledge - 6 Citations

Scopus - 7 Citations

Other information

Authenticus ID: P-003-REH

DOI: 10.1159/000212102

Abstract (EN): Background/Aims: The calcimimetic cinacalcet (Mimpara (R)/Sensipar (R)) simultaneously lowers parathyroid hormone (PTH), phosphorus (P) and calcium (Ca) levels in patients with secondary hyperparathyroidism. The OPTIMA study demonstrated that cinacalcet and adjusted doses of vitamin D maximized control of these parameters. This post-hoc analysis of OPTIMA data assessed the impact of reducing or increasing the dose of concomitant vitamin D on PTH, P and Ca in patients receiving cinacalcet. Methods: Dialysis patients with mean baseline intact PTH (iPTH) 300-800 pg/ml (31.8-84.8 pM) received doses of cinacalcet titrated to achieve an iPTH of 150-300 pg/ml (15.9-31.8 pM). The dose of vitamin D could then be decreased to further reduce serum P or Ca, or increased/initiated to further decrease PTH levels if iPTH >300 pg/ml or to increase Ca if Ca <8.0 mg/dl (2.0 mM). Results: Vitamin D dose was assessed for 345 patients during a 23-week period. A total of 91 and 129 patients had an increase or decrease in vitamin D dose, respectively. By study end, mean iPTH, P, and Ca were similar in both vitamin D groups, although there were differences in biochemical parameters between groups at the start of the study. There were statistically significant reductions from baseline to study end in iPTH and Ca in both groups (p < 0.001). Although P was significantly reduced by week 23 in the group in which vitamin D dose was decreased (p = 0.007), the reduction in P was less and did not achieve significance in the group in which vitamin D dose was increased (p = 0.71). Conclusions: After initiating cinacalcet, the dose of vitamin D can be adjusted to maximize reductions in PTH, P and Ca; however, vitamin D-induced decreases in PTH need to be balanced with the diminished response in P and Ca. Copyright (C) 2009 S. Karger AG, Basel

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10