Treatment with cinacalcet decreases systolic blood pressure in haemodialysed patients with chronic kidney disease and secondary hyperparathyroidism

Abstract

Background There are numerous evidences suggesting that parathyroid hormone (PTH) plays a role in the pathogenesis of arterial hypertension. Treatment with cinacalcet decreases serum PTH concentration in haemodialysed patients with chronic kidney disease (HDP) and secondary hyperparathyroidism (sHPT) Chronic kidney disease is a pro-inflammatory state. The aim of this study was therefore to assess the influence of 6-month treatment with cinacalcet on blood pressure (BP) and inflammation markers in HDP with sHPT.

Material and methods In 58 HDP with sHPT serum PTH, interleukin-6, C-reactive protein, calcium and phosphate concentrations were assessed before the first dose of cinacalcet and after 3 and 6 months of treatment. BP was measured before haemodialysis sessions.

Results Serum PTH concentration decreased significantly after 3 and 6 months of cinacalcet treatment from 1138 (931–1345) to 772 (551–992); p < 0.0001 and to 635 (430–839) pg/ml; p < 0.0001, respectively. Systolic BP decreased after 3 and 6 months of treatment from 128 (123–133), to 125 (120–131) and to 121 (115–127) mm Hg, respectively (p for trend = 0.014). Diastolic BP did not change significantly. There were no significant differences in the number of antihypertensive drugs, vitamin D analogues dose and patients’ body weight, nor the serum concentrations of IL-6 and CRP during the treatment period.

Conclusions 1. Six-month treatment with cinacalcet decreases systolic BP in haemodialysed patients with chronic kidney disease and secondary hyperparathyroidism. 2. The elucidation of exact pathomechanism of such a BP decrease needs further clinical studies, but it seems not to be related to inflammatory status changes.