Mawad Habib, Bouchard Hugues, Tran Duy, Ouimet Denis, Lafrance Jean-Philippe, Bell Robert Zoël, Bezzaoucha Sarah, Boucher Anne, Collette Suzon, Pichette Vincent, Senécal Lynne, Vallée Michel
Division of Nephrology, Maisonneuve-Rosemont Hospital and the Department of Medicine, University of Montreal, Montreal, QC, Canada.
J Transplant. 2017;2017:8720283. doi: 10.1155/2017/8720283. Epub 2017 Mar 13.
The primary objective of this study is to evaluate the use of cinacalcet in the management of hyperparathyroidism in kidney transplant recipients. The secondary objective is to identify baseline factors that predict cinacalcet use after transplantation. In this single-center retrospective study, we conducted a chart review of all patients having been transplanted from 2003 to 2012 and having received cinacalcet up to kidney transplantation and/or thereafter. Twenty-seven patients were included with a mean follow-up of 2.9 ± 2.4 years. Twenty-one were already taking cinacalcet at the time of transplantation. Cinacalcet was stopped within the first month in 12 of these patients of which 7 had to restart therapy. The main reason for restarting cinacalcet was hypercalcemia. Length of treatment was 23 ± 26 months. There were only 3 cases of mild hypocalcemia. There was no statistically significant association between baseline factors and cinacalcet status a year later. Discontinuing cinacalcet within the first month of kidney transplantation often leads to hypercalcemia. Cinacalcet appears to be an effective treatment of hypercalcemic hyperparathyroidism in kidney transplant recipients. Further studies are needed to evaluate safety and long-term benefits.
本研究的主要目的是评估西那卡塞在肾移植受者甲状旁腺功能亢进管理中的应用。次要目的是确定移植后预测西那卡塞使用的基线因素。在这项单中心回顾性研究中，我们对2003年至2012年期间所有接受移植且在肾移植时和/或之后接受西那卡塞治疗的患者进行了病历审查。纳入了27例患者，平均随访时间为2.9±2.4年。其中21例在移植时已在服用西那卡塞。这些患者中有12例在第一个月内停用了西那卡塞，其中7例不得不重新开始治疗。重新开始使用西那卡塞的主要原因是高钙血症。治疗时间为23±26个月。仅有3例轻度低钙血症。一年后基线因素与西那卡塞使用情况之间无统计学显著关联。肾移植后第一个月内停用西那卡塞常导致高钙血症。西那卡塞似乎是肾移植受者高钙性甲状旁腺功能亢进的有效治疗方法。需要进一步研究以评估其安全性和长期益处。
