The use of cinacalcet after pediatric renal transplantation: an international CERTAIN Registry analysis.
Adolescent
Calcimimetic Agents
/ administration & dosage
Child
Cinacalcet
/ administration & dosage
Dose-Response Relationship, Drug
Female
Humans
Hyperparathyroidism, Secondary
/ drug therapy
Kidney Failure, Chronic
/ complications
Kidney Transplantation
Male
Off-Label Use
Pilot Projects
Registries
Retrospective Studies
Transplant Recipients
Calcimimetics
Children
Renal transplantation
Secondary hyperparathyroidism
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
11
11
2019
accepted:
27
03
2020
revised:
18
03
2020
pubmed:
6
5
2020
medline:
16
6
2021
entrez:
6
5
2020
Statut:
ppublish
Résumé
Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce. In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx. The results are presented as median and interquartile range (25th-75th percentile). At 13.7 (11.0-16.5) years of age, 20 pediatric patients received a renal allograft. Cinacalcet was introduced at 0.4 (0.3-2.7) years post-transplant at an estimated glomerular filtration rate (eGFR) of 50 (34-66) mL/min/1.73 m This pilot study suggests that cinacalcet as off-label therapy for SHPT after pediatric RTx is efficacious in controlling post-transplant SHPT with acceptable tolerability. Continuing cinacalcet even with normal PTH can lead to dangerous life-threatening hypocalcemia. Therefore, at each subsequent visit, the need to continue cinacalcet must be assessed.
Sections du résumé
BACKGROUND
Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce.
METHODS
In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx. The results are presented as median and interquartile range (25th-75th percentile).
RESULTS
At 13.7 (11.0-16.5) years of age, 20 pediatric patients received a renal allograft. Cinacalcet was introduced at 0.4 (0.3-2.7) years post-transplant at an estimated glomerular filtration rate (eGFR) of 50 (34-66) mL/min/1.73 m
CONCLUSIONS
This pilot study suggests that cinacalcet as off-label therapy for SHPT after pediatric RTx is efficacious in controlling post-transplant SHPT with acceptable tolerability. Continuing cinacalcet even with normal PTH can lead to dangerous life-threatening hypocalcemia. Therefore, at each subsequent visit, the need to continue cinacalcet must be assessed.
Identifiants
pubmed: 32367310
doi: 10.1007/s00467-020-04558-8
pii: 10.1007/s00467-020-04558-8
doi:
Substances chimiques
Calcimimetic Agents
0
Cinacalcet
UAZ6V7728S
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM