Association of Nodular Hyperplasia With Resistance to Cinacalcet Therapy for Secondary Hyperparathyroidism in Hemodialysis Patients
Article first published online: 3 AUG 2010
© 2010 The Authors. Journal compilation © 2010 International Society for Apheresis
Therapeutic Apheresis and Dialysis
Volume 14, Issue 6, pages 577–582, December 2010
How to Cite
Hirai, T., Nakashima, A., Takasugi, N. and Yorioka, N. (2010), Association of Nodular Hyperplasia With Resistance to Cinacalcet Therapy for Secondary Hyperparathyroidism in Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 14: 577–582. doi: 10.1111/j.1744-9987.2010.00843.x
- Issue published online: 30 NOV 2010
- Article first published online: 3 AUG 2010
- Received January 2010; revised March 2010.
- Nodular hyperplasia;
- Secondary hyperparathyroidism
There have been few long-term prospective studies investigating the effect of cinacalcet on secondary hyperparathyroidism with or without nodular hyperplasia. We examined whether the effect of cinacalcet on secondary hyperparathyroidism differed between patients with or without nodular hyperplasia. Stable hemodialysis patients with secondary hyperparathyroidism resistant to conventional treatment received cinacalcet for 12 months. Based on ultrasonography findings, patients were divided into group S (gland < 500 mm3 without nodular hyperplasia) and group L (gland ≥ 500 mm3 with nodular hyperplasia). Serum levels of intact parathyroid hormone, bone-specific alkaline phosphatase, osteocalcin, and cross-linked N-terminal telopeptide of type 1 collagen were measured. Thirty-one patients completed the study. The changes of parameters from the baseline did not differ significantly between the two groups after 6 months. However, the percentage reduction of each parameter was significantly smaller in group L compared with group S after 12 months. Nodular hyperplasia is associated with resistance to cinacalcet therapy in patients on chronic dialysis with secondary hyperparathyroidism.