Effect of cinacalcet in the treatment of hemodialysis induced hyperparathyroidism and its impact on the nutritional status of patients

ZHANG Hui; LIU Fuping; WANG Ying

doi:10.3969/j.issn.1674-3245.2025.06.022

Abstract：Objective To observe the efficacy of cinacalcet combined with calcitriol in the treatment of secondary hyperparathyroidism(SHPT)in maintenance hemodialysis patients and its impact on the nutritional status of patients.Methods Chronic kidney disease patients who experienced SHPT and malnutrition during hemodialysis at Linquan County People's Hospital from February 2023 to March 2024 were selected as the research subjects,96 patients were randomly divided into two groups,with 48 patients in each group.Patients were given standardized nutritional management,with the control group receiving calcitriol capsules and the cinacalcet group receiving oral cinacalcet therapy in addition to the control group.Compare the serum calcium,phosphorus,and iPTH levels between the two groups at the time of enrollment,6 months of treatment,and 12 months of treatment.Upper arm circumference(MAC),triceps skinfold thickness(TSF),upper arm muscle circumference(AMC),and malnutrition inflammation score(MIS)were calculated.Compare two groups of adverse reactions.Results After 6 and 12 months of treatment,both groups had serum phosphorus and iPTH levels lower than baseline(t=3.239、3.469、6.853、4.852,P<0.05).The serum phosphorus and iPTH levels in the 6-month and 12-month cinacalcet groups were lower than those in the control group(P<0.05).At 6 and 12 months of treatment,both groups demonstrated a progressive upward trend in MAC,TSF and AMC.At 12 months,the AMC in the cinacalcet group was significantly higher than that in the control group,with a statistically significant between-group difference(t=2.979,P<0.05).Similarly,the MIS showed a gradual decline in both groups.The cinacalcet group exhibited lower MIS scores compared to the control group at both 6 months(12.72±3.19 vs.14.35±2.81)and 12 months(9.67±2.89 vs.11.94±3.73),with statistically significant differences(P<0.05 for both time points).There was no statistically significant difference in the incidence of adverse reactions between the two groups,χ2=0.489,P=0.484.Conclusion For patients with secondary hyperparathyroidism after maintenance hemodialysis,the combination of cinacalcet can effectively reduce parathyroid hormone and serum phosphorus levels,improve nutritional status,and enhance muscle function.