scholarly journals Serum phosphorus reduction in dialysis patients treated with cinacalcet for secondary hyperparathyroidism results mainly from parathyroid hormone reduction

2013 ◽  
Vol 6 (3) ◽  
pp. 287-294 ◽  
Author(s):  
E. Zitt ◽  
D. Fouque ◽  
S. H. Jacobson ◽  
F. Malberti ◽  
M. Ryba ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Serum Phosphorus ◽  
Dialysis Patients ◽  
Phosphorus Reduction

scholarly journals Is serum phosphorus control related to parathyroid hormone control in dialysis patients with secondary hyperparathyroidism?

2012 ◽  
Vol 13 (1) ◽  
Author(s):  
João M Frazão ◽  
Johann Braun ◽  
Piergiorgio Messa ◽  
Bastian Dehmel ◽  
Caroline Mattin ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Serum Phosphorus ◽  
Dialysis Patients ◽  
Phosphorus Control ◽  
Hormone Control

scholarly journals Control of hyperparathyroidism with the intravenous calcimimetic etelcalcetide in dialysis patients adherent and non-adherent to oral calcimimetics

2020 ◽  
Author(s):  
Maria Dolores Arenas ◽  
Cristian Rodelo-Haad ◽  
M Victoria Pendón-Ruiz de Mier ◽  
Mariano Rodriguez
Keyword(s):  
Parathyroid Hormone ◽  
Standard Deviation ◽  
Secondary Hyperparathyroidism ◽  
Serum Phosphate ◽  
Dialysis Patients ◽  
Serum Parathyroid Hormone ◽  
Apparent Lack ◽  
Serum Pth ◽  
And Control ◽  
Possible Cause

Abstract Background In dialysis patients, non-adherence to oral cinacalcet adds complexity to the control of secondary hyperparathyroidism. The present study aims to evaluate the use of intravenous calcimimetic, etelcalcetide, in the control of secondary hyperparathyroidism in patients adherent and non-adherent to oral calcimimetics. Method The Simplified Medication Adherence Questionnaire was used to identify non-adherence. Almost half of the patients were non-adherent to the treatment with cinacalcet. Twenty-five patients (15 non-adherent) were switched from cinacalcet to etelcalcetide and were followed-up monthly for 8 months. Results Cinacalcet was discontinued for 1 week before the initiation of etelcalcetide. After this period, the serum PTH levels increased by2-fold in adherent patients, whereas it did not change in non-adherent patients suggesting that they were not taking the medication. Etelcalcetide progressively reduced serum parathyroid hormone (PTH) (mean ± standard deviation) from 818 ± 395 to 367 ± 289 pg/mL (P < 0.001) in non-adherents, and from 496 ± 172 to 228 ± 111 pg/mL (P < 0.01) in adherent patients with a mean dose of 7.0 ± 2.3 and 5.1 ± 1.2 mg in non-adherent and in adherent patients, respectively. Etelcalcetide increased the percentage of patients with PTH on target from 28% to 58%. Patients with serum calcium <8.4 mg/dL increased from 8% to 40%, although they remained asymptomatic. The percent of patients with serum phosphate on target increased from 40% to 65%. Conclusion The lack of adherence to cinacalcet is a possible cause of the apparent lack of response to oral calcimimetic. The use of etelcalcetide ensures compliance and control of secondary hyperparathyroidism in both non-adherent and adherent patients.

Relationship between Serum Magnesium, Parathyroid Hormone, and Vascular Calcification in Patients on Dialysis: A Literature Review

2006 ◽  
Vol 26 (3) ◽  
pp. 366-373 ◽  
Author(s):  
Mingxin Wei ◽  
Khaled Esbaei ◽  
Joanne Bargman ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Vascular Calcification ◽  
Phosphate Binder ◽  
Inverse Relationship ◽  
Serum Magnesium ◽  
Magnesium Carbonate ◽  
Dialysis Patients ◽  
The Relationship

Secondary hyperparathyroidism is present in most patients with end-stage renal disease and has been linked to uremic bone disease, vascular calcification, and mortality. Current literature suggests an association between hypomagnesemia and cardiovascular disease in the general population. We reviewed all published studies on the relationship between serum magnesium and parathyroid hormone and the relationship between serum Mg and vascular calcification in dialysis patients. Of these, 10 of 12 studies of patients on hemodialysis and 4 of 5 studies of patients on peritoneal dialysis showed a significant inverse relationship between serum Mg and serum intact parathyroid hormone. Hyperparathyroidism develops in peritoneal dialysis patients dialyzed with a solution containing normal calcium (1.25 mmol/L) and low Mg (0.25 mmol/L), even though serum calcium is maintained at a normal level. Four of the hemodialysis studies and one of the peritoneal dialysis studies indicated that there is an inverse relationship between serum Mg and vascular calcification in these patients. Potential benefits have been attributed to magnesium carbonate as a phosphate binder and it may possibly be an effective, less toxic, less expensive phosphate binder. We believe that the role of Mg in secondary hyperparathyroidism and vascular calcification merits further investigation.

A radioimmunoassay for human parathyroid hormone utilizing a goat anti-bovine PTH serum

1981 ◽  
Vol 96 (2) ◽  
pp. 215-221 ◽  
Author(s):  
L. E. Mallette
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Human Serum ◽  
Central Region ◽  
Antigenic Site ◽  
Human Parathyroid Hormone ◽  
Domestic Goat ◽  
Standard Serum ◽  
Dilution Curves

Abstract. An antiserum (NG-1) against bovine PTH (bPTH) generated in the domestic goat was characterized for use in the radioimmunoassay of PTH in human serum. When a carboxyterminal fragment of bPTH is used as radioligand, this antiserum detects only an antigenic site in the central region of the hPTH molecule. The synthetic hormone fragment, hPTH-(44-68), will displace 93% of the tracer, after which the addition of intact hPTH causes no further displacement. The assay does not detect the synthetic aminoterminal 1-34 fragment of the bovine or human hormones, nor the carboxyterminal fragment of the human hormone, hPTh-(53-84). Standard curves with bPTH-(1-84) and partially purified hPTH are not parallel, so that hPTH is used as standard. Serum from subjects with uraemia or primary hyperparathyroidism gives dilution curves parallel to that with the hPTH standard. The assay with NG-1 has been applied to the diagnosis of primary and secondary hyperparathyroidism, used to monitor the disappearance of PTH after parathyroidectomy, and for measurement of PTH in selective venous samples.

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