Clinical Study

Long-Term Clinical Practice Experience with Cinacalcet for Treatment of Hypercalcemic Hyperparathyroidism after Kidney Transplantation

Table 1

Baseline characteristics of 44 patients treated with cinacalcet for hypercalcemic hyperparathyroidism following kidney transplantation (KT).

Median (IQR)/count (frequency, %)

Age, years56 (48–61)
Men, (%)29 (66)
Deceased-donor KT, (%)41 (93)
Previous transplants: 0/1/2, (%)36/4/4 (82/9/9)
Dialysis prior to KT, (%)42 (96)
Time on dialysis prior to KT, years3.2 (2.4–4.3)
Time between first renal replacement therapy until inclusion, years6.0 (4.5–10.3)
Time between last KT and development of hypercalcemia, months1.0 (0.5–2.1)
Time between last KT and cinacalcet initiation, years1.8 (0.8–4.7)
Laboratory findings, unit (reference range)
 Estimated glomerular filtration rate, mL/min/1.73 m251.2 (43.5–57.8)
 Total serum calcium, mmol/L (2.10–2.60)2.77 (2.68–2.84)
 Fractional calcium excretion, % (1-2)0.77 (0.44–1.45)
 Serum inorganic phosphate, mmol/L (0.81–1.45)0.79 (0.72–0.89)
 TmP/GFR, mmol/L (0.80–1.40)0.54 (0.46–0.63)
 Intact parathyroid hormone, pg/mL156 (112–236)
 Bone specific alkaline phosphatase, ng/mL (5.2–24.6)23.1 (16.8–32.9)
 Osteocalcin, ng/mL (15–35)54.6 (37.7–91.8)
 C-telopeptide, ng/mL (0.08–0.44)0.65 (0.43–1.02)
Native kidney disease, (%)
 Polycystic disease12 27.3
 Glomerular disease11 25.0
 Vascular disease3 6.8
 Diabetes mellitus2 4.5
 Others7 15.9
 Unknown9 20.5
Immunosuppressive therapy, (%)
 Cyclosporine A/tacrolimus17/22 (38.6/50.0)
 Mycophenolate mofetil/azathioprine/leflunomide40/1/1 (90.9/2.3/2.3)
 Sirolimus/everolimus1/1 (2.3/2.3)
 Belatacept2 4.5
 Steroids40 90.9
Pretransplant use of cinacalcet, (%)13 29.5

IQR, interquartile range; KT, kidney transplantation; TmP/GFR, renal tubular reabsorption of phosphate to glomerular filtration rate.