Efficacy of cinacalcet for end-stage renal disease patients with secondary hyperparathyroidism:a Meta-analysis
10.11958/20150067
- VernacularTitle:西那卡塞对终末期肾病患者继发性甲状旁腺功能亢进影响的Meta分析
- Author:
Zhe WANG
;
Fang WEI
;
Haiyan CHEN
;
Aili JIANG
- Publication Type:Journal Article
- Keywords:
receptors,calcium-sensing;
renal dialysis;
hyperparathyroidism,secondary;
Meta-analysis;
cinacalcet;
cal-cimimetic;
end-stage renal disease
- From:
Tianjin Medical Journal
2016;44(5):642-648
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of cinacalcet on secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). Methods Patients with ESRD and SHPT for the treatment with calcimimetic agents were included in this study. MEDLINE (1996.1-2014.9), OVID (1963.1-2014.9), Chinese Wanfang database (1996.1-2014.9), CNKI (1996.1-2014.9) and the clinical control test database of Cochrane Library were searched . Related literature, including published or unpublished papers, and meeting procedding were hand-searched. Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was conducted by RevMan 5.2. Results Nineteen randomized controlled trials involving 7 702 patients were included. The meta-analysis showed that compared with conventional therapy,cinacalcet can significantly decrease serum parathyroid hormone in dialysis patients [WMD=-301.54 μg/L, 95%CI:(-344.38)-(-258.7)μg/L, P<0.05], decrease serum level of calcium [WMD=-8.3 mg/L, 95%CI:(-9.1)-(-7.4)mg/L, P<0.05], and decrease serum level of phosphorus [WMD=-3.4 mg/L, 95%CI:(-4.6)-(-2.3) mg/L, P<0.05]. The total incidence of adverse events was similar (RR=1.03, 95%CI:0.98-1.09, P>0.05). Cinacalcet increased nausea (RR =2.05, 95%CI :1.53-2.75, P<0.05), vomiting (RR =2.00, 95%CI:1.78-2.23, P<0.05), diarrhea (RR=1.15, 95%CI:1.03-1.30, P<0.05), and asymptomatic hypocalcaemia (RR=7.60, 95%CI:5.61-10.30, P<0.05), but they were usually transient, and mild to moderate in severity. The mortality was similar (RR=0.97, 95%CI:0.89-1.05, P>0.05). Conclusion Results confirm that cinacalcet suppresses parathyroid hormone and decreases calcium and phosphorus in secondary hyperparathyroidism patients receiving dialysis. Cinacalcet increases risks of nausea, vomiting, diarrhea and hypocalcaemia,without increasing mortality.
