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Secondary hyperparathyroidism (SHTP) is a common complication in patients with end-stage kidney disease. There are several drugs for the treatment of this disease, such as the injectable calcimimetic etelcalcetide (ET).
The aim of this study was to evaluate the efficacy of ET for SHTP treatment in Argentina.
A descriptive, retrospective, observational and multicenter study was conducted with patients older than 18 years on maintenance hemodialysis (HD) in Argentina. Patients with SHTP with at least 3 months (m) of treatment with ET that have initial and control values of parathyroid hormone (PTH), calcium (C), phosphorus (P) and alkaline phosphatase (ALP) were included.
Variables such as age, sex, time on HD, history of diabetes mellitus (DBT), dialysate calcium concentration and concomitant use of vitamin D and P binders were analyzed.
Continuous variables are presented as median and interquartile range (IQR; 25%-75%) or mean and standard deviation as appropriate, and categorical variables as nominal and percentages. T test or Mann Whitney test were used to compare two independent groups, according to variable distribution. One-way Anova or Friedman tests were used to compare 3 or more related groups. The statistical analysis was made with SPSS 24. A p value less than 0.05 was considered statistically significant.
A total of 196 patients were included in the analysis. Mean age was 52 ± 15 years, 52.3% were male, 16.2% had DBT; the median time on HD was 46.5 (20-72) months. 91 (46.4%) patients received ET as the initial treatment for SHTP and 105 (53.6%) were switched from cinacalcet (Table 1).
Treatment with ET was effective in lowering PTH and P values. ET is a good option for patients with SHTP. Even though the C went down, hypocalcemia was not a cause of ET discontinuation. ET reduced PTH > 30% from 3 m and maintained at 1 and 2 years of treatment.