Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients

Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dial...

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Main Authors: Kyle Ying-kit Lin, Fiona Fung-yee Lai, Eugene Yu-hin Chan, Bradley A. Warady
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Kidney International Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924020540
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author Kyle Ying-kit Lin
Fiona Fung-yee Lai
Eugene Yu-hin Chan
Bradley A. Warady
author_facet Kyle Ying-kit Lin
Fiona Fung-yee Lai
Eugene Yu-hin Chan
Bradley A. Warady
author_sort Kyle Ying-kit Lin
collection DOAJ
description Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dialysis continues to experience secondary or even tertiary hyperparathyroidism. Cinacalcet, a calcimimetic agent, has been shown to be a promising therapeutic option to control hyperparathyroidism with reasonable safety profiles in adults and older children. Nevertheless, there is a paucity of data and guidance pertaining to its use among the younger children on dialysis, who are often the most challenging patients to manage with severe CKD-MBD. In this review, we summarize the available evidence on cinacalcet use among pediatric patients, especially infants and young children aged < 3 years. We also discuss the unique considerations in management and attempt to provide a pragmatic approach regarding the use of cinacalcet in this specific patient population.
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series Kidney International Reports
spelling doaj-art-b3bdd880605541ff8902829ed8e937d32025-08-20T02:06:00ZengElsevierKidney International Reports2468-02492025-03-0110369670610.1016/j.ekir.2024.11.032Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right PatientsKyle Ying-kit Lin0Fiona Fung-yee Lai1Eugene Yu-hin Chan2Bradley A. Warady3Paediatric Nephrology Center, Hong Kong Children’s Hospital, Hong Kong SAR, ChinaPaediatric Nephrology Center, Hong Kong Children’s Hospital, Hong Kong SAR, China; Department of Pharmacy, Hong Kong Children’s Hospital, Hong Kong SAR, ChinaPaediatric Nephrology Center, Hong Kong Children’s Hospital, Hong Kong SAR, China; Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China; Correspondence: Eugene Yu-hin Chan, Pediatric Nephrology Center, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong SAR, China.Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, Missouri, USA; Bradley A. Warady, Division of Nephrology, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, Missouri 64108, USA.Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dialysis continues to experience secondary or even tertiary hyperparathyroidism. Cinacalcet, a calcimimetic agent, has been shown to be a promising therapeutic option to control hyperparathyroidism with reasonable safety profiles in adults and older children. Nevertheless, there is a paucity of data and guidance pertaining to its use among the younger children on dialysis, who are often the most challenging patients to manage with severe CKD-MBD. In this review, we summarize the available evidence on cinacalcet use among pediatric patients, especially infants and young children aged < 3 years. We also discuss the unique considerations in management and attempt to provide a pragmatic approach regarding the use of cinacalcet in this specific patient population.http://www.sciencedirect.com/science/article/pii/S2468024924020540childrencinacalcetCKD-MBDdialysisESKDpediatric nephrology
spellingShingle Kyle Ying-kit Lin
Fiona Fung-yee Lai
Eugene Yu-hin Chan
Bradley A. Warady
Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
Kidney International Reports
children
cinacalcet
CKD-MBD
dialysis
ESKD
pediatric nephrology
title Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
title_full Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
title_fullStr Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
title_full_unstemmed Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
title_short Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients
title_sort cinacalcet for infants and young children on maintenance dialysis determining the right time the right dose and the right patients
topic children
cinacalcet
CKD-MBD
dialysis
ESKD
pediatric nephrology
url http://www.sciencedirect.com/science/article/pii/S2468024924020540
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AT eugeneyuhinchan cinacalcetforinfantsandyoungchildrenonmaintenancedialysisdeterminingtherighttimetherightdoseandtherightpatients
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