Cinacalcet Lowers FGF-23 Level Together with Bone Metabolism in Hemodialyzed Patients with Secondary Hyperparathyroidism

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2011 Aug 30

PMID 21874285

Citations 5

Authors

Tomasz Hryszko

Szymon Brzosko

Alicja Rydzewska-Rosolowska

Ewa Koc-Zorawska

Michal Mysliwiec

Affiliations

Soon will be listed here.

Abstract

Purpose: Secondary hyperparathyroidism (sHPT) is associated with elevated levels of FGF-23, which in turn are connected to adverse outcomes in ESRD patients. The relationship between FGF-23 and bone metabolism in patients with sHPT treated with cinacalcet has not been studied.

Methods: Thirty-four stable chronically hemodialyzed patients with sHPT were prospectively followed during the treatment with cinacalcet without any changes in concurrent vitamin D or phosphate binder dose. Blood samples were collected at the start and after 6 months of study. Levels of osteocalcin (OC), cross-linked C-telopeptide of type I collagen (CTX), and FGF-23 were measured.

Results: Eighteen patients finished the study. Levels of calcium, phosphate, and iPTH decreased during 6 months of treatment with cinacalcet. Serum level of FGF-23 decreased significantly (log FGF-23 from 7.58 ± 1.7 to 6.61 ± 1.7 pg/ml) (P < 0.001). Cinacalcet lowered the concentration of CTX from 3.1 ± 0.6 ng/ml to 2.6 ± 0.9 ng/ml (P < 0.05) and OC from 91.8 (41.5-558.6) to 70.3 (11.3-419.7) ng/ml (P < 0.05). The magnitude of change in FGF-23 concentration before and after treatment correlated significantly with suppression of osteoblasts' function assessed by ΔOC (r = 0.5, P < 0.05) but not with changes in bone resorption marker ΔCTX.

Conclusions: Cinacalcet treatment of sHPT results in reduction of FGF-23 levels, probably due to the suppression of osteoblasts function.

Citing Articles

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Thiem U, Lenz J, Haller M, Pasch A, Smith E, Cejka D Clin Kidney J. 2024; 17(6):sfae097.

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Effects of etelcalcetide on fibroblast growth factor 23 in patients with secondary hyperparathyroidism receiving hemodialysis.

Wolf M, Block G, Chertow G, Cooper K, Fouqueray B, Moe S Clin Kidney J. 2020; 13(1):75-84.

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Effect of Cinacalcet and Vitamin D Analogs on Fibroblast Growth Factor-23 during the Treatment of Secondary Hyperparathyroidism.

Sprague S, Wetmore J, Gurevich K, da Roza G, Buerkert J, Reiner M Clin J Am Soc Nephrol. 2015; 10(6):1021-30.

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Long-term clinical practice experience with cinacalcet for treatment of hypercalcemic hyperparathyroidism after kidney transplantation.

Thiem U, Gessl A, Borchhardt K Biomed Res Int. 2015; 2015:292654.

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Fibroblast growth factor 23: associations with cardiovascular disease and mortality in chronic kidney disease.

Negri A Int Urol Nephrol. 2013; 46(1):9-17.

PMID: 23296792 DOI: 10.1007/s11255-012-0370-2.

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