Cinacalcet efficacy and safety

Chronic kidney disease (CKD) alters the regulation of calcium and phosphate homeostasis, leading to secondary hyperparathyroidism, metabolic bone disease, soft tissue calcifications, and other metabolic derangements that have a significant impact on morbidity and mortality. The parathyroid gland is the central organ responsible for regulating these adaptive responses. Suppression of parathyroid hormone (PTH) secretion, hypertrophy, and hyperplasia are major goals in the treatment of CKD. Data in the medical literature suggest that cinacalcet simultaneously reduces parameters of bone metabolism, independently of a patient’s grade of secondary hyperparathyroidism,helping to improve their prognosis. Studies published in recent years demonstrate cinacalcet’s positive effect on parathyroid gland hyperplasia, the risk of parathyroidectomy, progression of vascular calcification, renal osteodystrophy,and the risk of mortality and/or cardiovascular events. Keywords: cinacalcet; secondary hyperthyroidism; chronic kidney disease; primary hyperthyroidism; parathyroid carcinoma; vascular calcification. Received: May 15, 2013; Accepted: August 9, 2013; Published: October 24, 2013. Corresponding Author: Josep Bonet, Nephrology Department, Hospital Universitari Germans, Trias I Pujol. Ctra Canyet s/n, 08916 Badalona, Spain. E-mail: jbonet.germanstrias@gencat.cat