Cinacalcet for secondary hyperparathyroidism in end-stage renal disease patients below age 5 years

Safety and Efficacy of Cinacalcet in Children Aged Under 3 Years on Maintenance Dialysis

“…Different from previous small studies, height SDS did not significantly improve, despite major reduction of exceedingly high PTH values. 27 , 32 This suggests that control of PTH has no major effect on growth, which is in line with observations from the International Pediatric Peritoneal dialysis Network registry with large patient numbers. 37 Although our data did not show a significant impact of cinacalcet on longitudinal growth, this conclusion must be considered speculative due to the missing data, the short follow-up time and the use of recombinant growth hormone in 7 patients.…”

“… 26 Significant reduction of PTH levels was also reported in observational studies in 92 children. 27 , 28 , 29 , 30 , 31 , 32 , 33 Thus, cinacalcet was licensed in children aged >3 years in Europe; the 2020 European consensus statement suggested routine cinacalcet use in pediatric patients on dialysis who are aged >3 years to treat persistent and severe sHPT, despite optimized conventional management. 5 However, this treatment remains unlicensed in the USA.…”

Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce

“…Calcimimetics are not licensed in children under 3 years of age [ 39 ], but some authors have reported their use in infants with advanced CKD or on dialysis, however with greater average doses at initiation than the current guidelines in older children (0.2 mg/kg/day to begin, maximum 2.5 mg/kg/day), as illustrated in Table 2 [ 35 , 36 ]. Cinacalcet in combination with recombinant human growth hormone (rhGH) treatment was associated with a significant improvement of standardized height in children undergoing dialysis and aged less than 5 years; treatment was effective in decreasing PTH levels and well tolerated [ 36 ]. In the second study, cinacalcet was given to 10 infants (median age 18 months) on dialysis, with a significant median overall decline in PTH of 82% from baseline by 6 months; the median effective dose required to reach such a control was 2.8 mg/kg/day (IQR 2.0; 3.1) [ 35 ].…”

Effect of High-Quality Whole-Course Care on Psychological Status and Postoperative Pharyngeal Complications in Patients Undergoing Surgery for Hyperparathyroidism Secondary to Chronic Rrenal Failure

“…Medical drug therapy and hemodialysis are currently the main treatment methods for CRF-SHPT patients, but about 50% of them still cannot relieve the clinical symptoms of SHPT after medical drugs or hemodialysis, and can gradually progress to refractory or progressive disease, at which point the patient will require surgical treatment ( 4 , 5 ). However, these patients undoubtedly increase the risk of surgery due to long-term hemodialysis and combined multisystemic pathologies, such as impaired coagulation mechanisms, hypoproteinemia, and renal anemia ( 6 ). In addition, the operation itself is a stressful event for the patient, which often brings greater psychological pressure to the patient.…”