PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic.
摘要：
■Etelcalcalcetide是一种静脉注射拟钙剂，有效降低维持性血液透析（HD）患者的甲状旁腺激素水平。肾移植时停用etelcalcalcetide的临床影响尚不清楚。
■我们回顾性审查了2015年1月1日至2022年12月12日在我们机构接受肾脏移植的所有符合预定标准的HD患者。甲状旁腺切除术的发生率和钙的演变，磷酸盐,和移植后完整的甲状旁腺激素（iPTH）水平根据移植前拟钙剂治疗的类型进行分析（西那卡塞vs.etelcalcalcetidevs.none).
■总的来说，包括372名患者（年龄53岁；四分位距[IQR]：42-62岁）。在移植的时候,35、75和262例患者接受了etelcalcetide治疗，Cinacalcet,或者没有拟钙剂，分别。1064（IQR：367-1658）天后，甲状旁腺切除术的发生率，Cinacalcet,无拟钙剂组为29%，12%,1%,分别(P<0.001)。调整年龄后，Etelcalcalcetide与甲状旁腺切除术的发生率增加有关，性别,和HD年份（风险比[HR]：97.0，95％置信区间[CI]：19.1-493.9，P<0.001）。甲状旁腺切除术的发生率与etelcalcetide剂量有关（≥10mg患者的6/11[54.6％]与4/24[16.7%]在<10mg的患者中，P=0.02)。此外，峰值钙水平较高(P<0.001)，甲状旁腺切除术较早(中位数80vs.480天,与西那卡塞组相比，依托钙钙肽组的P<0.001）。长期移植物功能，移植物丢失，和死亡率相似。
■与西那卡塞或无拟钙剂相比，在维持HD期间使用Etelcalcetide与移植后早期甲状旁腺切除术的发生率增加相关。
■我们回顾性审查了2015年1月1日至2022年12月12日在我们机构接受肾脏移植的所有符合预定标准的HD患者。甲状旁腺切除术的发生率和钙的演变，磷酸盐,和移植后完整的甲状旁腺激素（iPTH）水平根据移植前拟钙剂治疗的类型进行分析（西那卡塞vs.etelcalcalcetidevs.none).
■总的来说，包括372名患者（年龄53岁；四分位距[IQR]：42-62岁）。在移植的时候,35、75和262例患者接受了etelcalcetide治疗，Cinacalcet,或者没有拟钙剂，分别。1064（IQR：367-1658）天后，甲状旁腺切除术的发生率，Cinacalcet,无拟钙剂组为29%，12%,1%,分别(P<0.001)。调整年龄后，Etelcalcalcetide与甲状旁腺切除术的发生率增加有关，性别,和HD年份（风险比[HR]：97.0，95％置信区间[CI]：19.1-493.9，P<0.001）。甲状旁腺切除术的发生率与etelcalcetide剂量有关（≥10mg患者的6/11[54.6％]与4/24[16.7%]在<10mg的患者中，P=0.02)。此外，峰值钙水平较高(P<0.001)，甲状旁腺切除术较早(中位数80vs.480天,与西那卡塞组相比，依托钙钙肽组的P<0.001）。长期移植物功能，移植物丢失，和死亡率相似。
■与西那卡塞或无拟钙剂相比，在维持HD期间使用Etelcalcetide与移植后早期甲状旁腺切除术的发生率增加相关。
