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NDT Advance Access originally published online on November 28, 2007
Nephrology Dialysis Transplantation 2008 23(4):1387-1395; doi:10.1093/ndt/gfm776
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Effects of cinacalcet on gastrointestinal hormone release in patients with secondary hyperparathyroidism undergoing dialysis

Juan J. Díez1, Jose Luis Miguel2, Rosa Codoceo3, Pedro Iglesias4, M. Auxiliadora Bajo2, Carmen Sánchez2, Gloria del Peso2, Fernando Gil2, Jorge Martinez-Ara2, Pilar González Gancedo3 and Rafael Selgas2

1 Department of Endocrinology, Hospital Ramón y Cajal 2 Department of Nephrology, Hospital La Paz 3 Department of Biochemistry, Hospital La Paz, Madrid, 4 Department of Endocrinology, Hospital General, Segovia, Spain

Juan J. Díez, Department of Endocrinology, Hospital Ramón y Cajal, Carretera de Colmenar km 9, 28034 Madrid, Spain. E-mail: mibarsd{at}infomed.es



  Abstract

Objective. Our aim has been evaluating the influence of an acute dose of cinacalcet on the gastrointestinal hormonal responses to a test meal in uraemic patients with secondary hyperparathyroidism undergoing peritoneal dialysis (PD) or haemodialysis (HD).

Methods. Twenty patients (11 PD, 9 HD) on cinacalcet treatment (30–120 mg/day) were studied. Twelve patients (1 PD, 11 HD) who never received cinacalcet were studied as control group. Each patient received a test meal with blood samples at 0, 2 and 4 h. At 0 time, patients in the cinacalcet group received their usual oral dose of this calcimimetic. Plasma concentrations of intact parathyroid hormone (PTH), vasoactive intestinal peptide (VIP), ghrelin, substance P, serotonin, cholecystokinin (CCK) and gastrin were quantified at 0, 2 and 4 h.

Results. No significant differences in baseline concentrations of serum VIP, ghrelin, substance P, serotonine, CCK and gastrin were found between controls and cinacalcet-treated patients. In comparison with the control group, cinacalcet administration was followed by a significant decrease in VIP concentration at 4 h and a significant increase in substance P at 4 h. However, the areas under the curves of all studied gut hormones were similar in both groups.

Conclusion. An acute dose of cinacalcet exerts minimal influence on gut hormone responses to a mixed meal in dialysis patients on chronic therapy with this drug. The small but significant differences between control subjects and patients on cinacalcet in VIP and substance P levels at 4 h should be investigated in symptomatic patients.

Keywords: chronic kidney disease; cinacalcet; dialysis; gastrointestinal hormones; secondary hyperparathyroidism

Received for publication: 16. 7.07
Accepted in revised form: 4.10.07


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