Effectiveness of cinacalcet in patients with recurrent/persistent secondary hyperparathyroidism following parathyroidectomy: results of the ECHO study

Nephrol Dial Transplant. 2011 Jun;26(6):1956-61. doi: 10.1093/ndt/gfq641. Epub 2010 Oct 14.


Background: Progressive secondary hyperparathyroidism (sHPT) is characterized by parathyroid gland hyperplasia which may ultimately require parathyroidectomy (PTX). Although PTX is generally a successful treatment for those patients subjected to surgery, a significant proportion develops recurrent sHPT following PTX. ECHO was a pan-European observational study which evaluated the achievement of KDOQI(TM) treatment targets with cinacalcet use in patients on dialysis. Previously published results showed that cinacalcet plus flexible vitamin D therapy lowered serum PTH, phosphorus and calcium in the clinical practice with similar efficacy as seen in phase III trials.

Methods: This subgroup analysis of ECHO describes the real-world cinacalcet treatment effect in patients with recurrent or persistent sHPT after PTX (n = 153) compared to sHPT patients without prior history of PTX (n = 1696).

Results: Both groups of patients had substantially elevated serum PTH with comparable sHPT severity at baseline. After 12 months of cinacalcet treatment, 20.3% (26/128) of patients with prior PTX and 18.2% (253/1388) of patients without prior PTX achieved serum PTH and Ca × P values within the recommended KDOQI(TM) target ranges.

Conclusions: Our data support the successful use of cinacalcet in patients with recurrent/persistent sHPT after PTX.

MeSH terms

  • Aged
  • Calcium / blood
  • Cinacalcet
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperparathyroidism, Secondary / drug therapy*
  • Hyperparathyroidism, Secondary / etiology*
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Naphthalenes / therapeutic use*
  • Parathyroid Hormone / blood
  • Parathyroidectomy / adverse effects*
  • Phosphorus / blood
  • Recurrence
  • Renal Dialysis
  • Survival Rate
  • Treatment Outcome
  • Vitamin D / administration & dosage


  • Naphthalenes
  • Parathyroid Hormone
  • Vitamin D
  • Phosphorus
  • Calcium
  • Cinacalcet