Association Between Resistance to Cinacalcet and Parathyroid Gland Hyperplasia in Kidney Transplant Recipients with Persistent Hypercalcemia

Association Between Resistance to Cinacalcet and Parathyroid Gland Hyperplasia in Kidney Transplant Recipients with Persistent Hypercalcemia

Persistent hypercalcemia and hyperparathyroidism after successful kidney transplantation can be detrimental in some recipients and should be ameliorated. To point out the concerns regarding resistance to cinacalcet in kidney transplant recipients with persistent hypercalcemia. 14 renal transplant re...

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Bibliographic Details
Published in:International journal of organ transplantation medicine Vol. 11; no. 3; pp. 107 - 112
Main Authors: Oruc, A, Ersoy, A, Kocaeli, A A, Yildiz, A, Gul, O O, Ertürk, E, Ersoy, C
Format: Journal Article
Language:English
Published: Iran Shiraz University of Medical Sciences 01-01-2020
Avicenna Organ Transplantation Institute
Subjects:
Contraindications
Creatinine
Drug dosages
Drug withdrawal
Endocrine system
Hypercalcemia
Hyperplasia
Kidney diseases
Kidney transplants
Laboratories
Original
Patients
Phosphorus
Scintigraphy
Studies
Surgery
Tumors
Ultrasonic imaging
Hypercalcemia
Parathyroid adenoma
Parathyroidectomy
Cinacalcet
Kidney transplantation
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Summary:Persistent hypercalcemia and hyperparathyroidism after successful kidney transplantation can be detrimental in some recipients and should be ameliorated. To point out the concerns regarding resistance to cinacalcet in kidney transplant recipients with persistent hypercalcemia. 14 renal transplant recipients who received cinacalcet treatment because of persistent hypercalcemia were included in the study. Serum creatinine, estimated glomerular filtration rate (eGFR), calcium, phosphorus, and intact parathyroid hormone (PTH) levels at the baseline and throughout the treatment, and ultrasonography and parathyroid scintigraphy findings were recorded. Cinacalcet treatment was initiated after a mean±SD of 20.7±19.7 months of transplantation and maintained for 16.9±7.9 months. Serum calcium levels were significantly decreased with the cinacalcet treatment. There were no significant changes in serum creatinine, eGFR, phosphorus, and PTH levels. In all participants, serum calcium levels were increased from 9.8±0.6 to 11.1±0.6 mg/dL (p<0.001) within 1 month of cessation of cinacalcet. 7 recipients with adenoma-like hyperplastic glands underwent parathyroidectomy (PTx) due to failure with cinacalcet. Cinacalcet may be an appropriate treatment for a group of recipients with hypercalcemia without adenoma-like hyperplastic glands or who had a contraindication for surgery. Recipients with enlarged parathyroid gland may resist to cinacalcet-induced decrease in serum PTH, although the concomitant hypercalcemia may be corrected.
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ISSN:2008-6482
2008-6490