Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Ther Apher Dial. 2024 Aug;28(4):557-571. doi: 10.1111/1744-9987.14125. Epub 2024 Mar 18.
Several calcimimetics, other than cinacalcet, are commercially available; however, their effects on calcium and phosphate levels have not yet been fully studied. We conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the impact of calcimimetics on the management of serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis.
A systematic literature search through October 2023 and a meta-analysis were conducted on the effects of upacicalcet, etelcalcetide, evocalcet, and cinacalcet on serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis; we searched PubMed, Ovid MEDLINE, and the Cochrane Central Register of Controlled Trials, and 21 studies comprising 6371 patients undergoing dialysis were included.
Participants treated with calcimimetics had lower serum calcium and phosphate levels than placebo.
Calcimimetics significantly reduced serum calcium and phosphate levels compared to placebo in patients with secondary hyperparathyroidism undergoing dialysis, independent of therapeutic strategy or concomitant vitamin D treatment.
除了西那卡塞，还有几种钙敏感受体激动剂已上市；然而，它们对钙和磷水平的影响尚未得到充分研究。我们进行了一项系统评价和荟萃分析，以评估钙敏感受体激动剂对接受透析治疗的继发性甲状旁腺功能亢进症患者血清钙和磷水平管理的影响。
我们对截至 2023 年 10 月的文献进行了系统检索，并对接受透析治疗的继发性甲状旁腺功能亢进症患者中西那卡塞、依特卡塞、埃卡塞特和盐酸西那卡塞对血清钙和磷水平的影响进行了荟萃分析；我们检索了 PubMed、Ovid MEDLINE 和 Cochrane 对照试验中心注册库，并纳入了 21 项包含 6371 名接受透析治疗的患者的研究。
与安慰剂相比，接受钙敏感受体激动剂治疗的患者血清钙和磷水平较低。
与安慰剂相比，接受透析治疗的继发性甲状旁腺功能亢进症患者中，钙敏感受体激动剂可显著降低血清钙和磷水平，与治疗策略或同时使用维生素 D 治疗无关。
