Dotis John, Printza Nikoleta, Ghogha Chrisa, Papachristou Fotios
J Pediatr Endocrinol Metab. 2013;26(1-2):39-43. doi: 10.1515/jpem-2012-0214.
Secondary hyperparathyroidism (HPT) constitute a high-turnover bone disease, manifested by elevated parathyroid hormone. Cinacalcet, belonging to calcimimetics, has been shown to be promising in the control of secondary HPT with limited data in children.
To evaluate the safety and efficacy of cinacalcet in children on peritoneal dialysis (PD) with secondary HPT.
Four patients on PD with severe secondary HPT, uncontrolled with phosphorus dietary restrictions combined with phosphate binders and analog of 1,25 vitamin D3 received cinacalcet.
After cinacalcet treatment, in two of four patients, we found a serum intact parathyroid hormone (iPTH) level reduction by more than 70% at 4 weeks and more than 60% at 3 or more than 6 months. Nevertheless, in the other two patients, a transient reduction of iPTH was found in 4 weeks and an increase in 3 or more months, who were finally treated with surgical parathyroidectomy. During cinacalcet treatment, no adverse events were noted.
Cinacalcet may be a safe and effective treatment for PD patients with secondary HPT, although surgical parathyroidectomy cannot be avoided in certain cases.
继发性甲状旁腺功能亢进（HPT）是一种高转换型骨病，表现为甲状旁腺激素升高。西那卡塞属于钙敏感受体激动剂，已被证明在控制继发性HPT方面有前景，但儿童相关数据有限。
评估西那卡塞对接受腹膜透析（PD）的继发性HPT儿童患者的安全性和有效性。
4例接受PD且患有严重继发性HPT的患者，在采用饮食磷限制联合磷结合剂及1,25维生素D3类似物治疗无效后，接受了西那卡塞治疗。
西那卡塞治疗后，4例患者中有2例在4周时血清完整甲状旁腺激素（iPTH）水平降低超过70%，在3个月或6个月以上时降低超过60%。然而，另外2例患者在4周时iPTH出现短暂降低，在3个月或更长时间时升高，最终接受了甲状旁腺切除术。在西那卡塞治疗期间，未观察到不良事件。
西那卡塞可能是治疗继发性HPT的PD患者的一种安全有效的方法，尽管在某些情况下无法避免甲状旁腺切除术。
