Center on Aging and Mobility, University Hospital, University of Zürich, Rämistrasse 100, Switzerland.
Kidney Blood Press Res. 2011;34(2):97-103. doi: 10.1159/000323902. Epub 2011 Jan 27.
Cinacalcet effectively reduces calcium in patients with persistent hyperparathyroidism (HPT) after kidney transplantation. We aimed to assess the association of cinacalcet with a decrease in renal function based on a meta-analysis of observational studies in kidney transplant patients with persistent HPT.
Meta-analysis of observational studies, no randomized controlled studies were available. We calculated the mean difference between renal function before cinacalcet and at 3 months on cinacalcet treatment for each study. Pooled analyses are based on random effects models.
Pooling the studies on kidney transplant patients with persistent HPT (8 studies, n = 115), we found a significant reduction in renal function (p = 0.008). The effect size was 5 μmol/l (p < 0.0001) when pooling the 7 studies where serum creatinine levels were reported. Meta-regression analysis revealed that there was an association between renal function and the amount of calcium reduction under treatment with cinacalcet. A higher delta change in serum calcium levels was associated with a decrease in renal function at 3 months of cinacalcet treatment.
Cinacalcet treatment was associated with a decline of renal function in kidney transplant recipients with persistent HPT. Our meta-analysis underscores the need for frequent monitoring of creatinine and calcium levels during cinacalcet treatment.
西那卡塞可有效降低肾移植后持续性甲状旁腺功能亢进症（HPT）患者的血钙水平。本研究旨在通过对持续性 HPT 肾移植患者的观察性研究进行荟萃分析，评估西那卡塞与肾功能下降的相关性。
对观察性研究进行荟萃分析，未纳入随机对照研究。我们计算了每一项研究中西那卡塞治疗前和治疗 3 个月肾功能的均值差。汇总分析基于随机效应模型。
汇总了 8 项持续性 HPT 肾移植患者的研究（n = 115），我们发现肾功能显著下降（p = 0.008）。当汇总报告血清肌酐水平的 7 项研究时，效应量为 5 μmol/l（p < 0.0001）。Meta 回归分析显示，西那卡塞治疗期间肾功能与钙减少量之间存在相关性。治疗期间血清钙水平的变化与西那卡塞治疗 3 个月时肾功能下降相关。
西那卡塞治疗与持续性 HPT 肾移植受者的肾功能下降有关。本荟萃分析强调了在西那卡塞治疗期间需要频繁监测肌酐和钙水平。
