Affiliation:
1. Department of Nephrology, the Second Affiliated Hospital, Shantou University Medical College, 515041, Shantou, China
Abstract
Background:
Some reports have pointed out that calcimimetics agents are effective in the treatment of
secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients, but there is no detailed description
of the advantages and disadvantages of calcimimetics agents of SHPT in CKD patients. We tried to pool
the published data to verify the effectiveness of calcimimetics agents and to compare the advantages and disadvantages
of cinacalcet compared with control in the treatment of SHPT in CKD patients.
Methods:
We included eligible studies of published papers from January 1st, 2000 to December 31st, 2020 in
Medline, Pubmed and Web of science databases, and the data were extracted for this meta-analysis.
Results:
Twenty-seven studies were eligible, and all the included studies were randomized controlled trials
(RCT) including patients treated with long-term dialysis. The results indicated that calcimimetic agents can
reduce the parathyroid hormone (PTH, pg/ml) level (WMD = -178.22, 95% CI: -238.57, -117.86, P < 0.00001),
calcium (Ca, mg/dl) level (WMD = -0.71, 95% CI: -0.86, -0.55, P < 0.00001), phosphorus (P, mg/dl) level
(WMD = -0.32, 95% CI: -0.55, -0.08, P = 0.008), calcium-phosphorus product level (WMD = -7.73, 95% CI:
-9.64, -5.82, P < 0.00001). Calcimimetic agents increased the bone alkaline phosphatase (BSAP, ng/ml) levels
and rate of achieving target PTH, and reduced osteocalcin levels and the rate of parathyroidectomy. Calcimimetic
agents increased the total adverse events’ rate, the rate of hypocalcemia and gastrointestinal side effects
(nausea, vomiting, abdominal pain and diarrhea), but there was no significant difference in serious adverse
events between the calcimimetic agent group and control group.
Conclusion:
Calcimimetic agents can reduce the PTH level, Ca level, P level, calcium-phosphorus product
level and do not increase serious adverse events.
Publisher
Bentham Science Publishers Ltd.
Subject
Drug Discovery,Pharmacology
Cited by
1 articles.
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