Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation
Introduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patie...
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Elsevier
2024-07-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924016243 |
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| author | Philippe Delaey Arnaud Devresse Johann Morelle Danai Faitatzidou Miren Iriarte Nada Kanaan Antoine Buemi Michel Mourad Tom Darius Eric Goffin Michel Jadoul Laura Labriola Pierre-Yves Decleire Marie Rommelaere Miguel-Ange Guillen Benoit Buysschaert Bénédicte Vanderperren Charles Cuvelier Benoît Georges Eugenia Papakrivopoulou Claude Braun Gaëlle Gillerot Jean-Philippe Lengelé François Reginster Philippe Leroy Ann-Karolien Vandooren Philippe Madhoun |
| author_facet | Philippe Delaey Arnaud Devresse Johann Morelle Danai Faitatzidou Miren Iriarte Nada Kanaan Antoine Buemi Michel Mourad Tom Darius Eric Goffin Michel Jadoul Laura Labriola Pierre-Yves Decleire Marie Rommelaere Miguel-Ange Guillen Benoit Buysschaert Bénédicte Vanderperren Charles Cuvelier Benoît Georges Eugenia Papakrivopoulou Claude Braun Gaëlle Gillerot Jean-Philippe Lengelé François Reginster Philippe Leroy Ann-Karolien Vandooren Philippe Madhoun |
| author_sort | Philippe Delaey |
| collection | DOAJ |
| description | Introduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patients on HD meeting predefined criteria who received a kidney transplant at our institution between January 1, 2015, and December 12, 2022. The incidence of parathyroidectomy and the evolution of calcium, phosphate, and intact parathyroid hormone (iPTH) levels after transplantation was analyzed according to the type of calcimimetic treatment before transplantation (cinacalcet vs. etelcalcetide vs. none). Results: Overall, 372 patients (aged 53 years; interquartile range [IQR]: 42–62 years) were included. At the time of transplantation, 35, 75, and 262 patients were under etelcalcetide, cinacalcet, or no calcimimetic, respectively. After 1064 (IQR: 367–1658) days, the incidences of parathyroidectomy in the etelcalcetide, cinacalcet, no calcimimetic groups were 29%, 12%, and 1%, respectively (P < 0.001). Etelcalcetide was associated with an increased incidence of parathyroidectomy after adjustment for age, sex, and HD vintage (hazard ratio [HR]: 97.0, 95% confidence interval [CI]: 19.1–493.9, P < 0.001). The incidence of parathyroidectomy was related to etelcalcetide dosage (6/11 [54.6%] in patients with ≥ 10 mg vs. 4/24 [16.7%] in patients with < 10 mg, P = 0.02). Moreover, peak calcium levels were higher (P < 0.001) and parathyroidectomy was performed earlier (median 80 vs. 480 days, P < 0.001) in the etelcalcetide compared with the cinacalcet group. Long-term graft function, graft loss, and mortality were similar. Conclusion: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic. |
| format | Article |
| id | doaj-art-643ab09a894649d88ae0eb083a1ac03a |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-643ab09a894649d88ae0eb083a1ac03a2025-08-20T03:45:03ZengElsevierKidney International Reports2468-02492024-07-01972146215610.1016/j.ekir.2024.04.004Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney TransplantationPhilippe Delaey0Arnaud Devresse1Johann Morelle2Danai Faitatzidou3Miren Iriarte4Nada Kanaan5Antoine Buemi6Michel Mourad7Tom Darius8Eric Goffin9Michel Jadoul10Laura Labriola11Pierre-Yves DecleireMarie RommelaereMiguel-Ange GuillenBenoit BuysschaertBénédicte VanderperrenCharles CuvelierBenoît GeorgesEugenia PapakrivopoulouClaude BraunGaëlle GillerotJean-Philippe LengeléFrançois ReginsterPhilippe LeroyAnn-Karolien VandoorenPhilippe MadhounDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, BelgiumDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium; Division of Abdominal and Transplant Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, BelgiumDivision of Nephrology, University Hospitals Namur (CHU UCL Namur), Namur, BelgiumDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Division of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Division of Nephrology, Hospital del Mar, Barcelona, SpainDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, BelgiumDivision of Abdominal and Transplant Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, BelgiumDivision of Abdominal and Transplant Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, BelgiumDivision of Abdominal and Transplant Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, BelgiumDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, BelgiumDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, BelgiumDivision of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium; Correspondence: Laura Labriola, Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, Europe.Introduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patients on HD meeting predefined criteria who received a kidney transplant at our institution between January 1, 2015, and December 12, 2022. The incidence of parathyroidectomy and the evolution of calcium, phosphate, and intact parathyroid hormone (iPTH) levels after transplantation was analyzed according to the type of calcimimetic treatment before transplantation (cinacalcet vs. etelcalcetide vs. none). Results: Overall, 372 patients (aged 53 years; interquartile range [IQR]: 42–62 years) were included. At the time of transplantation, 35, 75, and 262 patients were under etelcalcetide, cinacalcet, or no calcimimetic, respectively. After 1064 (IQR: 367–1658) days, the incidences of parathyroidectomy in the etelcalcetide, cinacalcet, no calcimimetic groups were 29%, 12%, and 1%, respectively (P < 0.001). Etelcalcetide was associated with an increased incidence of parathyroidectomy after adjustment for age, sex, and HD vintage (hazard ratio [HR]: 97.0, 95% confidence interval [CI]: 19.1–493.9, P < 0.001). The incidence of parathyroidectomy was related to etelcalcetide dosage (6/11 [54.6%] in patients with ≥ 10 mg vs. 4/24 [16.7%] in patients with < 10 mg, P = 0.02). Moreover, peak calcium levels were higher (P < 0.001) and parathyroidectomy was performed earlier (median 80 vs. 480 days, P < 0.001) in the etelcalcetide compared with the cinacalcet group. Long-term graft function, graft loss, and mortality were similar. Conclusion: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic.http://www.sciencedirect.com/science/article/pii/S2468024924016243chronic hemodialysisetelcalcetidehyperparathyroidismkidney transplantationmineral metabolismparathyroidectomy |
| spellingShingle | Philippe Delaey Arnaud Devresse Johann Morelle Danai Faitatzidou Miren Iriarte Nada Kanaan Antoine Buemi Michel Mourad Tom Darius Eric Goffin Michel Jadoul Laura Labriola Pierre-Yves Decleire Marie Rommelaere Miguel-Ange Guillen Benoit Buysschaert Bénédicte Vanderperren Charles Cuvelier Benoît Georges Eugenia Papakrivopoulou Claude Braun Gaëlle Gillerot Jean-Philippe Lengelé François Reginster Philippe Leroy Ann-Karolien Vandooren Philippe Madhoun Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation Kidney International Reports chronic hemodialysis etelcalcetide hyperparathyroidism kidney transplantation mineral metabolism parathyroidectomy |
| title | Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation |
| title_full | Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation |
| title_fullStr | Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation |
| title_full_unstemmed | Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation |
| title_short | Etelcalcetide use During Maintenance Hemodialysis and Incidence of Parathyroidectomy After Kidney Transplantation |
| title_sort | etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation |
| topic | chronic hemodialysis etelcalcetide hyperparathyroidism kidney transplantation mineral metabolism parathyroidectomy |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924016243 |
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