NDT Advance Access published online on June 16, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn345
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Pharmacodynamic effects of cinacalcet after kidney transplantation: once- versus twice-daily dose
1 Department of Nephrology, Dialysis and Multi-Organ Transplantation, CHU Toulouse-Rangueil, Toulouse University Hospital, Toulouse 2 INSERM U858, IFR 31, 1 av. Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9 3 Laboratory of Biochemistry, CHU Purpan, Toulouse University Hospital, Toulouse 4 INSERM U563, IFR 30, 330 Ave. de Grande-Bretagne, TSA 40031, 31059 Toulouse Cedex 9 5 Laboratory of Pharmacology, CHU Purpan, Toulouse University Hosiptal, Toulouse, France
Correspondence and offprint requests to: Nassim Kamar, Department of Nephrology, Dialysis and Multi-Organ Transplantation, Toulouse University Hospital, Toulouse, France. Tel: +33-5-6132-2684; Fax: +33-5-6132-2864; E-mail: kamar.n{at}chu-toulouse.fr
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Abstract |
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Background. In the setting of kidney transplantation, cinacalcet has been given, mainly, once daily, but also twice daily. The aims of this prospective study were to assess the acute pharmacodynamic effect of cinacalcet administrated once or twice daily to kidney transplant patients with normal renal function and persisting hypercalcaemia due to hyperparathyroidism and to evaluate 1-year efficacy and tolerance of cinacalcet given at a dose of 30 mg b.i.d.
Methods. Eleven patients, who received a transplant 6 (6–59) months previously, were included in the study. A first kinetic was done after administration of 60 mg of cinacalcet at 8 a.m. After a washout period of 1 week, the second kinetic was performed with cinacalcet given at 30 mg b.i.d within a 12-h period.
Results. During both kinetics, serum calcium (sCa), ionized calcium (sCa2+), albumin-corrected Ca and parathyroid hormone (PTH) levels decreased significantly. At 24 h after the second kinetic, sCa2+ was significantly lower. After 1 year of cinacalcet treatment, given at the dose of 30 mg b.i.d., there was a significant decrease in sCa, sCa2+, PTH levels and calcium x phosphorus (Ph) product. In contrast, Ph levels increased significantly. There was no significant change in renal function.
Conclusion. Once- or twice-daily acute administration of cinacalcet to kidney-transplant patients has similar efficacy. One-year administration of cinacalcet, given as two daily doses, is safe and efficient.
Keywords: cinacalcet; daily dose; hyperparathyroidism; renal function; renal transplantation
Received for publication: 6. 4.08
Accepted in revised form: 26. 5.08