A prospective randomized study on intermittent post-dialysis dose regimen of Cinacalcet, single center experience

Abstract

Background:Treatment of secondary hyperparathyroidism (SHPT) is important in management of patients with end-stage kidney disease on  hemodialysis (HD). cinacalcet provides an option for the control of SHPT in patients who fail traditional therapy, It may not have optimal results in non-compliant patients.

Aim of the study:   The aim of this study is to evaluated effectiveness of post-dialysis dosing of   cinacalcet (three time \week),tolerability and adherence as compared to daily home administration.

Methods: prospective randomized controlled clinical trial carried out in Iraqi center of dialysis of Baghdad  teaching hospital –medical city complex during the period from March 2020 to January 2021. forty two patients with end-stage renal disease on hemodialysis (HD) with secondary hyperparathyroidism (SHPT),group (A) treated with daily dose of cinacalcit taking by patients at home and group (B) treated with post dialysis dosing  of  Cinacalcet(three times per week)were given  to patients  at the  dialysis center. Intact parathyroid hormone (i-PTH), serum calcium, phosphorus,albumin and alkaline phosphatase were followed every two weeks  for two month  and compared to baseline values  in both groups.

Results: A significant decline in i-PTH levels were detected  in group (A)        (p = 0.001)at two  months  therapy as compared to a non significant drop in group( B) (p=0.1)

Conclusions: The effectiveness of daily dosing of Cinacalcet is higher effectiveness than  intermittent dosing of Cinacalcet in treatment of patients with secondary hyperparathyroidism., no significant difference is recorded between daily dosing of Cinacalcet and intermittent dosing of Cinacalcet regarding  need for phosphate binders tablets, alfacalcidol tablet and side effects.