Experiencia inicial con cinacalcet en Argentina

  • Elisa Elena Del Valle Grupo de Metabolismo Óseo Mineral, Sociedad Argentina de Nefrología, Buenos Aires
  • Francisco Rodolfo Spivacow Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires
  • Gustavo Laham Fresenius Medical Care, Buenos Aires
  • Lucía Migueliz Servicio de Nefrología, CEMIC, Buenos Aires
  • Guillermo Rosa Diez Grupo de Metabolismo Óseo Mineral, Sociedad Argentina de Nefrología, Buenos Aires
  • Soledad Crucelegui Fresenius Medical Care, Buenos Aires
  • Cecilia Mengarelli Grupo de Metabolismo Óseo Mineral, Sociedad Argentina de Nefrología, Buenos Aires
  • Mónica Norbis Fresenius Medical Care, Buenos Aires
  • Marta Ecke Fresenius Medical Care, Buenos Aires
  • Sergio Liderman Fresenius Medical Care, Buenos Aires
  • Bruno Lococo Servicio de Nefrología, Hospital General de Agudos Dr. Juan A. Fernández, Buenos Aires
  • Adriana Peñalba Grupo de Metabolismo Óseo Mineral, Sociedad Argentina de Nefrología, Buenos Aires
  • Daniel Noli Fresenius Medical Care, Buenos Aires
  • Elisa Perazolo de Villois Fresenius Medical Care, Buenos Aires
  • Guillermo Petraglia Fresenius Medical Care, Buenos Aires
  • Marina Bravo Fresenius Medical Care, Buenos Aires
  • Ivanna Marin Fresenius Medical Care, Buenos Aires
  • Jorge Lobo Fresenius Medical Care, Buenos Aires
  • Manuel Canalis Fresenius Medical Care, Buenos Aires
  • Luciana González Paganti Fresenius Medical Care, Buenos Aires
  • Mariano Forrester Grupo de Metabolismo Óseo Mineral, Sociedad Argentina de Nefrología, Buenos Aires
  • Angela Vacca Fresenius Medical Care, Buenos Aires
  • Gustavo Aguirre Fresenius Medical Care, Buenos Aires

Resumen

Introducción: El hiperparatiroidismo secundario es una complicación frecuente de la enfermedad renal crónica. Cinacalcet, un moduladoralostérico del receptor sensor del calcio incrementa su sensibilidad a la activación por parte del calcio iónico extracelular, demostró ser efectivo en reducir los niveles de PTH. Objetivo: Evaluar la eficacia de cinacalcet en pacientes en hemodiálisis con HPTS. Material y métodos: Se realizó un estudio retrospectivo, multicéntrico, observacional, en 76 pacientes que recibieron al menos 3 meses de cinacalcet como tratamiento del HPTS. Resultados: La edad media fue 51±16 años, 61% eran varones. La mediana del tiempo en HD previo al inicio de cinacalcet fue 67 meses (43-109). El 40.8% completó el año de tratamiento. La mediana de PTH basal fue 1110 pg/ml (887-1477). Los niveles de PTH disminuyeron significativamente desde el primer mes de tratamiento 874(p<0.0001) al tercero 729 p<0.0001 y al sexto mes 602 p<0.0001. A partir del 9 mes permanecieron estables, logrando niveles objetivos de PTH en el 49% de los pacientes. La FAL bajó en forma significativa entre el 3 y 6 mes manteniéndose luego sin modificaciones. Descenso significativo en la calcemia (9.4mg/dl basal a 9 y 8.7 p< 0.0001) y fosfatemia (5.9 mg/dl basal a 5.5 y 5.3, p< 0.0001) al 1º y 3º mes de tratamiento. Conclusión: La dosis inicial de cinacalcet de 30 mg se aumentó significativamente al 3º y 6º mes (dosis media 50mg/día) pero sin modificaciones en el mes 9 y 12.

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Publicado
2015-01-01
Cómo citar
1.
Del Valle EE, Spivacow FR, Laham G, Migueliz L, Rosa Diez G, Crucelegui S, Mengarelli C, Norbis M, Ecke M, Liderman S, Lococo B, Peñalba A, Noli D, Perazolo de Villois E, Petraglia G, Bravo M, Marin I, Lobo J, Canalis M, González Paganti L, Forrester M, Vacca A, Aguirre G. Experiencia inicial con cinacalcet en Argentina. Rev Nefrol Dial Traspl. [Internet]. 1 de enero de 2015 [citado 28 de marzo de 2024];35(1):15-3. Disponible en: http://www.revistarenal.org.ar/index.php/rndt/article/view/132
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