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Cincalcet and Vascular Arterial Stiffness Among Peritoneal Dialysis Patients With Secondary Hyperparathyroidism

Phase 4
Completed
Conditions
Hyperparathyroidism
Arterial Stiffness
Interventions
Registration Number
NCT01143987
Lead Sponsor
Chinese University of Hong Kong
Brief Summary

Active parathyroid glands among renal dialysis patients contribute to calcified and hardened blood vessels. Such damage to the blood vessels, in turn, takes a significant toll in terms of cardiovascular disease. Calcimimetics has been suggested to lower the risk of vascular calcification. Role of cinacalcet was demonstrated in animal model but human data are lacking. The investigators designed an open label pilot study to evaluate the effect of cinacalcet in 20 peritoneal dialysis patients with inadequately controlled secondary hyperparathyroidism despite standard treatment. The primary outcome is the aortic pulse wave velocity at 26 and 52 months after cinacalcet treatment.

Detailed Description

Mineral metabolism disturbance and hyperparathyroidism contribute to arterial stiffness and vascular calcification. The vascular damage, in turn, contributes to significant cardiovascular morbidity and mortality of end-stage renal disease patients. Calcimimetics has been suggested to lower the risk of vascular calcification. Role of cinacalcet was demonstrated in animal model but human data are lacking. We design an open label pilot study to evaluate the effect of cinacalcet in 20 peritoneal dialysis patients with inadequately controlled secondary hyperparathyroidism despite standard treatment. The primary outcome is the aortic pulse wave velocity at 26 and 52 months after cinacalcet treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • plasma parathyroid hormone level of at least 300 pg/ml (31.8 pmol/L)
  • aged 18 or older on peritoneal dialysis for at least three months
  • willingness to give written consent and comply with the study protocol
Exclusion Criteria
  • evidence of cancer, active infection or diseases with limited life expectancy
  • diseases known to cause hypercalcaemia
  • adjusted serum calcium level below 2.1 mmol/L (8.4 mg/dL) after correction for albumin
  • participation in another interventional study within last 30 days of randomization
  • history of a psychological illness or condition that would interfere with the patient's ability to understand the requirement of the study and/or comply with the study procedures
  • patients receiving drugs with a narrow therapeutic index and metabolized by cytochrome P-450 2D6 (which is inhibited by cinacalcet): flecainide, thioridazine and most tricyclic antidepressants

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
CinacalcetCinacalcetOral cinacalcet
Primary Outcome Measures
NameTimeMethod
Aortic pulse wave velocity after the cinacalcet treatmentchange in aortic pulse wave velocity at 52 weeks from baseline

as before

Secondary Outcome Measures
NameTimeMethod
Change in calcium levelswithin one year of treatment with cinacalcet

as before

Aortic pulse wave velocity after the cinacalcet treatmentchange in aortic pulse wave velocity at 26 weeks from baseline

as stated in the description of Primary Outcome Measure

Percent change in the values for parathyroid hormone levelswithin one year of treatment with cinacalcet

Blood samples will be stored before and after treatment with cinacalcet for further analysis.

Change in phosphorus levelswithin one year of cinacalcet treatment

as before

Change in calcium-phosphorus productwithin one year of cinacalcet treatment

as before

Trial Locations

Locations (1)

Prince of Wales Hospital, Chinese University of Hong Kong

🇭🇰

Shatin, New Territories, Hong Kong

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