Article Text
Abstract
Background and importance Secondary hyperparathyroidism is a common complication in patients with chronic kidney failure undergoing haemodialysis. The use of calcimimetics is a suitable option for secondary hyperparathyroidism. Etelcalcetide is a synthetic peptide that binds to the calcium receptor causing a reduction in parathyroid hormone (PTH) secretion.
Aim and objectives To analyse the use of etelcalcetide in patients with secondary hyperparathyroidism due to chronic renal failure undergoing haemodialysis.
Material and methods A retrospective, descriptive, observational study was conduced including patients treated with etelcalcetide for a period of 6 months. The following variables were collected: demographics (age and sex); analytical measures (levels of PTH, corrected serum calcium and phosphate at the beginning of treatment and 6 months later; and therapeutic measures (initial average weekly dose of etelcalcetide and at 6 months and other concomitant treatments).
Results 45 patients were included with a mean age of 67±11.7 years; 62.2% were men. The initial mean weekly dose of etelcalcetide was 9.2±4.8 mg, increasing at 6 months to 10.5±5.4 mg.
Initial laboratory values for all patients were: PTH 476.6±328.6 pg/mL; corrected serum calcium 8.85±0.64 mg/dL; and phosphate 4.86±1.06 mg/dL. At 6 months, 25/45 patients (55.5%) had reduced PTH levels, with a mean percentage reduction of 25.7±19.8%. Of these 25 patients, 8 (40%) achieved a PTH reduction of ≥30%. Corrected serum calcium levels at 6 months decreased in 21/45 patients (46.7%), while phosphate levels decreased in 22/45 patients (49.9%). In addition, 25/45 patients (55.5%) were treated with a vitamin D analogue; 37/45 patients (82.2%) with phosphorus binders and 23/45 patients (51.1%) with both types of drugs.
Conclusion and relevance Etelcalcetide reduced PTH levels in more than 50% of the patients included in the study and can be considered an effective drug. Furthermore, the corrected serum calcium and phosphate concentrations remained within the optimal range in most patients.
Conflict of interest No conflict of interest