Renal function in patients treated with cinacalcet for persistent hyperparathyroidism after kidney transplantation

Kidney Blood Press Res. 2011;34(2):97-103. doi: 10.1159/000323902. Epub 2011 Jan 27.


Background and aim: Cinacalcet effectively reduces calcium in patients with persistent hyperparathyroidism (HPT) after kidney transplantation. We aimed to assess the association of cinacalcet with a decrease in renal function based on a meta-analysis of observational studies in kidney transplant patients with persistent HPT.

Method: Meta-analysis of observational studies, no randomized controlled studies were available. We calculated the mean difference between renal function before cinacalcet and at 3 months on cinacalcet treatment for each study. Pooled analyses are based on random effects models.

Results: Pooling the studies on kidney transplant patients with persistent HPT (8 studies, n = 115), we found a significant reduction in renal function (p = 0.008). The effect size was 5 μmol/l (p < 0.0001) when pooling the 7 studies where serum creatinine levels were reported. Meta-regression analysis revealed that there was an association between renal function and the amount of calcium reduction under treatment with cinacalcet. A higher delta change in serum calcium levels was associated with a decrease in renal function at 3 months of cinacalcet treatment.

Conclusion: Cinacalcet treatment was associated with a decline of renal function in kidney transplant recipients with persistent HPT. Our meta-analysis underscores the need for frequent monitoring of creatinine and calcium levels during cinacalcet treatment.

Publication types

  • Meta-Analysis

MeSH terms

  • Calcium / blood
  • Cinacalcet
  • Creatinine / blood
  • Humans
  • Hyperparathyroidism / drug therapy*
  • Hyperparathyroidism / physiopathology
  • Kidney Function Tests*
  • Kidney Transplantation*
  • Naphthalenes / adverse effects*
  • Naphthalenes / therapeutic use


  • Naphthalenes
  • Creatinine
  • Calcium
  • Cinacalcet