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The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis

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The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis. / Bernardor, Julie; Schmitt, Claus Peter; Oh, Jun; Sellier-Leclerc, Anne-Laure; Büscher, Anja; Dello Strologo, Luca; Genc, Gurkan; John, Ulrike; Weitz, Marcus; Zirngibl, Matthias; Krupka, Kai; Tönshoff, Burkhard; Bacchetta, Justine.

In: PEDIATR NEPHROL, Vol. 35, No. 9, 09.2020, p. 1707-1718.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Bernardor, J, Schmitt, CP, Oh, J, Sellier-Leclerc, A-L, Büscher, A, Dello Strologo, L, Genc, G, John, U, Weitz, M, Zirngibl, M, Krupka, K, Tönshoff, B & Bacchetta, J 2020, 'The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis', PEDIATR NEPHROL, vol. 35, no. 9, pp. 1707-1718. https://doi.org/10.1007/s00467-020-04558-8

APA

Bernardor, J., Schmitt, C. P., Oh, J., Sellier-Leclerc, A-L., Büscher, A., Dello Strologo, L., Genc, G., John, U., Weitz, M., Zirngibl, M., Krupka, K., Tönshoff, B., & Bacchetta, J. (2020). The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis. PEDIATR NEPHROL, 35(9), 1707-1718. https://doi.org/10.1007/s00467-020-04558-8

Vancouver

Bernardor J, Schmitt CP, Oh J, Sellier-Leclerc A-L, Büscher A, Dello Strologo L et al. The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis. PEDIATR NEPHROL. 2020 Sep;35(9):1707-1718. https://doi.org/10.1007/s00467-020-04558-8

Bibtex

@article{25bf6ef556874a10b98a9a5c2e75c5ab,
title = "The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis",
abstract = "BACKGROUND: Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce.METHODS: In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx. The results are presented as median and interquartile range (25th-75th percentile).RESULTS: At 13.7 (11.0-16.5) years of age, 20 pediatric patients received a renal allograft. Cinacalcet was introduced at 0.4 (0.3-2.7) years post-transplant at an estimated glomerular filtration rate (eGFR) of 50 (34-66) mL/min/1.73 m2, plasma calcium of 2.58 (2.39-2.71) mmol/L, age-standardized (z score) phosphate of - 1.7 (- 2.7-- 0.4), and PTH of 136 (95-236) ng/L. The starting dose of cinacalcet was 0.5 (0.3-0.8) mg/kg per day, with a maximum dose of 1.1 (0.5-1.3) mg/kg per day. With a follow-up of 3.0 (1.5-3.6) years on cinacalcet therapy, eGFR remained stable; PTH levels decreased to 66 (56-124) ng/L at the last follow-up (p = 0.015). One patient displayed hypocalcemia (1.8 mmol/L). Cinacalcet was withdrawn in three patients (hypocalcemia, parathyroidectomy, incompliance). Nephrocalcinosis of the graft was not reported.CONCLUSIONS: This pilot study suggests that cinacalcet as off-label therapy for SHPT after pediatric RTx is efficacious in controlling post-transplant SHPT with acceptable tolerability. Continuing cinacalcet even with normal PTH can lead to dangerous life-threatening hypocalcemia. Therefore, at each subsequent visit, the need to continue cinacalcet must be assessed.",
author = "Julie Bernardor and Schmitt, {Claus Peter} and Jun Oh and Anne-Laure Sellier-Leclerc and Anja B{\"u}scher and {Dello Strologo}, Luca and Gurkan Genc and Ulrike John and Marcus Weitz and Matthias Zirngibl and Kai Krupka and Burkhard T{\"o}nshoff and Justine Bacchetta",
year = "2020",
month = sep,
doi = "10.1007/s00467-020-04558-8",
language = "English",
volume = "35",
pages = "1707--1718",
journal = "PEDIATR NEPHROL",
issn = "0931-041X",
publisher = "Springer",
number = "9",

}

RIS

TY - JOUR

T1 - The use of cinacalcet after pediatric renal Transplantation: an international CERTAIN Registry analysis

AU - Bernardor, Julie

AU - Schmitt, Claus Peter

AU - Oh, Jun

AU - Sellier-Leclerc, Anne-Laure

AU - Büscher, Anja

AU - Dello Strologo, Luca

AU - Genc, Gurkan

AU - John, Ulrike

AU - Weitz, Marcus

AU - Zirngibl, Matthias

AU - Krupka, Kai

AU - Tönshoff, Burkhard

AU - Bacchetta, Justine

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND: Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce.METHODS: In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx. The results are presented as median and interquartile range (25th-75th percentile).RESULTS: At 13.7 (11.0-16.5) years of age, 20 pediatric patients received a renal allograft. Cinacalcet was introduced at 0.4 (0.3-2.7) years post-transplant at an estimated glomerular filtration rate (eGFR) of 50 (34-66) mL/min/1.73 m2, plasma calcium of 2.58 (2.39-2.71) mmol/L, age-standardized (z score) phosphate of - 1.7 (- 2.7-- 0.4), and PTH of 136 (95-236) ng/L. The starting dose of cinacalcet was 0.5 (0.3-0.8) mg/kg per day, with a maximum dose of 1.1 (0.5-1.3) mg/kg per day. With a follow-up of 3.0 (1.5-3.6) years on cinacalcet therapy, eGFR remained stable; PTH levels decreased to 66 (56-124) ng/L at the last follow-up (p = 0.015). One patient displayed hypocalcemia (1.8 mmol/L). Cinacalcet was withdrawn in three patients (hypocalcemia, parathyroidectomy, incompliance). Nephrocalcinosis of the graft was not reported.CONCLUSIONS: This pilot study suggests that cinacalcet as off-label therapy for SHPT after pediatric RTx is efficacious in controlling post-transplant SHPT with acceptable tolerability. Continuing cinacalcet even with normal PTH can lead to dangerous life-threatening hypocalcemia. Therefore, at each subsequent visit, the need to continue cinacalcet must be assessed.

AB - BACKGROUND: Secondary hyperparathyroidism (SHPT) may persist after renal transplantation (RTx), inducing hypophosphatemia and hypercalcemia that precludes the use of vitamin D analogs. The calcimimetic cinacalcet improved plasma calcium and parathyroid hormone (PTH) levels in randomized controlled trials in adults after RTx, but pediatric data are scarce.METHODS: In this retrospective study, we analyzed 20 pediatric patients from the Cooperative European Paediatric Renal TransplAnt Initiative (CERTAIN) Registry who received cinacalcet after RTx. The results are presented as median and interquartile range (25th-75th percentile).RESULTS: At 13.7 (11.0-16.5) years of age, 20 pediatric patients received a renal allograft. Cinacalcet was introduced at 0.4 (0.3-2.7) years post-transplant at an estimated glomerular filtration rate (eGFR) of 50 (34-66) mL/min/1.73 m2, plasma calcium of 2.58 (2.39-2.71) mmol/L, age-standardized (z score) phosphate of - 1.7 (- 2.7-- 0.4), and PTH of 136 (95-236) ng/L. The starting dose of cinacalcet was 0.5 (0.3-0.8) mg/kg per day, with a maximum dose of 1.1 (0.5-1.3) mg/kg per day. With a follow-up of 3.0 (1.5-3.6) years on cinacalcet therapy, eGFR remained stable; PTH levels decreased to 66 (56-124) ng/L at the last follow-up (p = 0.015). One patient displayed hypocalcemia (1.8 mmol/L). Cinacalcet was withdrawn in three patients (hypocalcemia, parathyroidectomy, incompliance). Nephrocalcinosis of the graft was not reported.CONCLUSIONS: This pilot study suggests that cinacalcet as off-label therapy for SHPT after pediatric RTx is efficacious in controlling post-transplant SHPT with acceptable tolerability. Continuing cinacalcet even with normal PTH can lead to dangerous life-threatening hypocalcemia. Therefore, at each subsequent visit, the need to continue cinacalcet must be assessed.

U2 - 10.1007/s00467-020-04558-8

DO - 10.1007/s00467-020-04558-8

M3 - SCORING: Journal article

C2 - 32367310

VL - 35

SP - 1707

EP - 1718

JO - PEDIATR NEPHROL

JF - PEDIATR NEPHROL

SN - 0931-041X

IS - 9

ER -