Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism
Kidney International, ISSN: 0085-2538, Vol: 87, Issue: 4, Page: 846-856
2015
- 146Citations
- 90Captures
- 2Mentions
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Metrics Details
- Citations146
- Citation Indexes145
- 145
- CrossRef116
- Policy Citations1
- Policy Citation1
- Captures90
- Readers90
- 90
- Mentions2
- News Mentions2
- News2
Most Recent News
Bone responsiveness to parathyroid hormone is negatively associated with parathyroid hormone-lowering drug use in patients undergoing hemodialysis: a cross-sectional study
Abstract Background Parathyroid hormone (PTH) acts on bone to indirectly increase the number and activity of osteoclasts. Thus, PTH has a stimulatory effect on bone
Article Description
The multicenter, single-arm BONAFIDE study characterized the skeletal response to cinacalcet in adult dialysis patients with plasma parathyroid hormone (PTH) levels of 300 pg/ml or more, serum calcium of 8.4 mg/dl or more, bone-specific alkaline phosphatase over 20.9 ng/ml and biopsy-proven high-turnover bone disease. Of 110 enrolled patients, 77 underwent a second bone biopsy with quantitative histomorphometry after 6–12 months of cinacalcet treatment. The median PTH decreased from 985 pg/ml at baseline to 480 pg/ml at the end of study (weeks 44–52). Bone formation rate/tissue area decreased from 728 to 336 μm 2 /mm 2 /day, osteoblast perimeter/osteoid perimeter decreased from 17.4 to 13.9%, and eroded perimeter/bone perimeter decreased from 12.7 to 8.3%. The number of patients with normal bone histology increased from none at baseline to 20 at 12 months. Two patients had adynamic bone at the end of study with a PTH under 150 pg/ml, and one patient with overt hypophosphatemia at baseline that reoccurred during follow-up developed osteomalacia. Thus, long-term treatment with cinacalcet substantially reduced PTH, diminished the elevated bone formation rate/tissue area, lowered several biochemical markers of high-turnover bone disease toward normal, and generally improved bone histology. Twenty patients had normal bone histology at follow-up, whereas most had mild hyperparathyroidism or mixed uremic osteodystrophy.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S0085253815302076; http://dx.doi.org/10.1038/ki.2014.349; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84926528769&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/25337774; https://linkinghub.elsevier.com/retrieve/pii/S0085253815302076; http://www.nature.com/doifinder/10.1038/ki.2014.349; http://www.nature.com/ki/journal/v87/n4/full/ki2014349a.html
Elsevier BV
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