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Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Secondary hyperparathyroidism (sHPT) is a common complication of chronic kidney disease and characterized by elevated intact serum parathyroid hormone (iPTH). Etelcalcetide is an intravenous calcimimetic that increases the sensitivity of the calcium-sensing receptor to calcium and decreases PTH secretion. Many dialysis patients have uncontrolled hyperparathyroidism despite using Calcium supplements, vitamin D analogs & oral calcimimetics (Cinacalcet). Etelcalcetide is a novel intravenous calcimimetic used for the treatment of secondary hyperparathyroidism in dialysis patients1 which has fewer Gastrointestinal (GI) side effects compared to oral calcimimetic.
This is single center retrospective study in Al Wakra Hospital dialysis unit. Over the study period from Jan 2021 to September 2025, patients who had poor compliance, GI side effects or uncontrolled secondary hyperparathyroidism while on oral calcimimetics (Cinacalcet) were switched to Etelcalcetide with a starting dose of 7.5-15 mg/week with gradual monthly dose titration guided by iPTH2, Calcium, Phosphorus & Alkaline phosphatase levels. Inclusion criteria: Adult (>18 years old) hemodialysis patient with two or more consecutive readings of iPTH level about 7 times the upper limit (600pg/mL) despite using vitamin D analogs & Cinacalcet for at least 3 months. Exclusion criteria: Patients’ age < 18 years, hemodialysis duration < 3 months. Etelcalcetide is already approved as part of secondary hyperparathyroidism treatment in the hospital.
Total number of patients included in the study was 46 patients (25 males and 21 females). The age range was 31 to 89 years with average age 56 years for males and 65 years for females. The average starting iPTH level was 963pg/mL and the highest 1947pm/mL. At 6 months of treatment, 54.3% and 28.5% of patients achieved iPTH < 600pg/mL and 601-800pg/mL, respectively. At the end of the study time 78% of patients were having iPTH level less than 800pg/mL. Corrected serum calcium level was maintained between 2.2 -2.55 mmol/L in 97.5 and 99.7% at 6 months and at the end of study time, respectively. During the study, 38 (82.6%) and 3 (6.5%) patients were treated with Alfacalcidol and Calcitriol, respectively. None of the patients developed a clinically significant hypocalcemia. None of the patients were required to stop treatment because of gastrointestinal side effects.
Calcium Level (mmol/l)
At Start
after 6 months
At study end
Calcium < 2.2
7
11
26
Calcium 2.2-2.55
34
24
19
Calcium > 2.55
5
1
0
Total
46
36
45
15.22%
30.56%
57.78%
74%
67%
42%
10.87%
2.78%
0.00%
Table1: Calcium level (mmol/l) for all patients at different stages of study time.
Phosphorus level (mmol/l)
Start
After 6 months
Sep. 2025
Phosphorus < 0.8
Phosphorus 0.8- 1.5
15
Phosphorus 1.51 - 2
17
14
18
Phosphorus 2.01 - 3
16
9
Phosphorus > 3.0
2
Patient number
23.91%
33.33%
Phosphorus 1.5 - 2
36.96%
38.89%
40.00%
Phosphorus 2.1 - 3
34.78%
25.00%
24.44%
4.35%
2.22%
Table 2: Phosphorus level (mmol/L) during different study stages.
1) Etelcalcetide is a safe and well tolerated novel treatment for challenging secondary hyperparathyroidism cases among hemodialysis patients.
2) Etelcalcetide is a very effective treatment for controlling iPTH.
3) Secondary hyperparathyroidism control can be achieved with well balanced and patient specific treatment regimens including Etelcalcetide.
4) Medication compliance and concordance can be improved significantly with IV Etelcalcetide treatment on dialysis for many patients.
