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Vol 19, No 3 (2015)
ORIGINAL PAPERS
Published online: 2015-09-29
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Treatment with cinacalcet decreases systolic blood pressure in haemodialysed patients with chronic kidney disease and secondary hyperparathyroidism

Piotr Kuczera, Marcin Adamczak, Andrzej Wiecek
DOI: 10.5603/AH.2015.0016
·
Arterial Hypertension 2015;19(3):129-134.

open access

Vol 19, No 3 (2015)
ORIGINAL PAPERS
Published online: 2015-09-29

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.

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.

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Keywords

chronic kidney disease, secondary hyperparathyroidism, cinacalcet, blood pressure, haemodialysis

About this article
Title

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

Journal

Arterial Hypertension

Issue

Vol 19, No 3 (2015)

Pages

129-134

Published online

2015-09-29

DOI

10.5603/AH.2015.0016

Bibliographic record

Arterial Hypertension 2015;19(3):129-134.

Keywords

chronic kidney disease
secondary hyperparathyroidism
cinacalcet
blood pressure
haemodialysis

Authors

Piotr Kuczera
Marcin Adamczak
Andrzej Wiecek

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