Premium
Long‐term results of a randomized study comparing parathyroidectomy with cinacalcet for treating tertiary hyperparathyroidism
Author(s) -
Moreno Pablo,
Coloma Ana,
Torregrosa José V.,
Montero Nuria,
Francos José,
Codina Sergi,
Malles Anna,
Bestard Oriol,
GarcíaBarrasa Arantxa,
Melilli Edoardo,
Cruzado Josep M.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13988
Subject(s) - cinacalcet , medicine , parathyroidectomy , tertiary hyperparathyroidism , secondary hyperparathyroidism , hyperparathyroidism , urology , surgery , kidney transplantation , parathyroid hormone , transplantation , calcium
Tertiary hyperparathyroidism is a common cause of hypercalcemia after kidney transplantation (KT) and has been associated with renal dysfunction, bone mineral density loss, and increased risk of fracture and cardiovascular events. In a previous 12‐month clinical trial, we demonstrated that subtotal parathyroidectomy was more effective than cinacalcet for controlling hypercalcemia. In the current study, we retrospectively evaluate whether this effect is maintained after 5 years of follow‐up. In total, 24 patients had data available at 5 years, 13 in the cinacalcet group and 11 in the parathyroidectomy group. At 5 years, 7 of 11 patients (64%) in the parathyroidectomy group and 6 of 13 patients (46%) in the cinacalcet group ( P = .44) showed normocalcemia. However, recurrence of hypercalcemia was only observed in the cinacalcet group ( P = .016). Subtotal parathyroidectomy retained a greater reduction in intact parathyroid hormone (iPTH) compared with cinacalcet group. No differences were observed in kidney function and incidence of fragility fractures between both groups. Cinacalcet was discontinued in 5 out of 13 patients. In conclusion, in kidney transplant patients with tertiary hyperparathyroidism recurrence of hypercalcemia after 5‐year follow‐up is more frequent in cinacalcet than after subtotal parathyroidectomy.