Tertiary Hyperparathyroidism Resistant to Cinacalcet Treatment
Article first published online: 19 MAY 2011
© 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis
Therapeutic Apheresis and Dialysis
Special Issue: Recent Advances in CKD-MBD Research - Masafumi Fukagawa and Tadao Akizawa, Guest Editors. The publication of this supplement has been supported by Chugai Pharmaceutical Co., Ltd
Volume 15, Issue Supplement s1, pages 33–37, June 2011
How to Cite
Okada, M., Tominaga, Y., Izumi, K., Nobata, H., Yamamoto, T., Hiramitsu, T., Tsujita, M., Goto, N., Nanmoku, K., Watarai, T. and Uchida, K. (2011), Tertiary Hyperparathyroidism Resistant to Cinacalcet Treatment. Therapeutic Apheresis and Dialysis, 15: 33–37. doi: 10.1111/j.1744-9987.2011.00924.x
- Issue published online: 19 MAY 2011
- Article first published online: 19 MAY 2011
- Received January 2011; revised January 2011.
- Cinacalcet hydrochloride;
- Nodular hyperplasia;
- Renal transplantation;
- Tertiary hyperparathyroidism
Cinacalcet hydrochloride (cinacalcet) has been reported to be efficacious for patients with tertiary hyperparathyroidism (THPT). We experienced five patients with THPT requiring parathyroidectomy (PTx) because of resistance to cinacalcet treatment and investigated their clinical characteristics and clinical course. The maximum diameter of the parathyroid gland estimated by ultrasonography before renal transplantation was evaluated. Serum total calcium, phosphorus, intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and creatinine (Cr) levels were investigated every three months after the administration of cinacalcet and at PTx. After surgery, the Cr levels were followed. In all five patients, at least one parathyroid gland had a largest diameter of more than 1 cm, and the mean diameter was 18.7 mm (range 14.9–24.1 mm). Intact PTH and ALP levels gradually increased after the initiation of cinacalcet and the Cr levels transiently increased after PTx. These findings suggest that the existence of a severely enlarged nodular hyperplastic gland is a main factor involved in resistance to cinacalcet.