Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

doi:10.1111/1744-9987.14125

Meta-Analysis

. 2024 Aug;28(4):557-571.

doi: 10.1111/1744-9987.14125. Epub 2024 Mar 18.

Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

Kentaro Nakai¹, Keiji Kono², Shunsuke Yamada³, Masatomo Taniguchi⁴, Takayuki Hamano⁵, Masafumi Fukagawa⁶

Affiliations

¹ Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
² Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Fukuoka Renal Clinic, Fukuoka, Japan.
⁵ Department of Nephrology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
⁶ Division of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.

PMID: 38499495
DOI: 10.1111/1744-9987.14125

Meta-Analysis

Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

Kentaro Nakai et al. Ther Apher Dial. 2024 Aug.

. 2024 Aug;28(4):557-571.

doi: 10.1111/1744-9987.14125. Epub 2024 Mar 18.

Authors

Kentaro Nakai¹, Keiji Kono², Shunsuke Yamada³, Masatomo Taniguchi⁴, Takayuki Hamano⁵, Masafumi Fukagawa⁶

Affiliations

¹ Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
² Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Fukuoka Renal Clinic, Fukuoka, Japan.
⁵ Department of Nephrology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
⁶ Division of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.

PMID: 38499495
DOI: 10.1111/1744-9987.14125

Abstract

Introduction: Several calcimimetics, other than cinacalcet, are commercially available; however, their effects on calcium and phosphate levels have not yet been fully studied. We conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the impact of calcimimetics on the management of serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis.

Methods: A systematic literature search through October 2023 and a meta-analysis were conducted on the effects of upacicalcet, etelcalcetide, evocalcet, and cinacalcet on serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis; we searched PubMed, Ovid MEDLINE, and the Cochrane Central Register of Controlled Trials, and 21 studies comprising 6371 patients undergoing dialysis were included.

Results: Participants treated with calcimimetics had lower serum calcium and phosphate levels than placebo.

Conclusion: Calcimimetics significantly reduced serum calcium and phosphate levels compared to placebo in patients with secondary hyperparathyroidism undergoing dialysis, independent of therapeutic strategy or concomitant vitamin D treatment.

Keywords: calcimimetics; dialysis; hyperparathyroidism; parathyroid hormone; vitamin D.

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References

REFERENCES

1. Shimamoto S, Yamada S, Hiyamuta H, Arase H, Taniguchi M, Tokumoto M, et al. Association of serum phosphate concentration with the incidence of intervention for peripheral artery disease in patients undergoing hemodialysis: 10‐year outcomes of the Q‐cohort study. Atherosclerosis. 2020 Jul;304:22–29. https://doi.org/10.1016/j.atherosclerosis.2020.04.022
1. Yamada S, Tsuruya K, Taniguchi M, Tokumoto M, Fujisaki K, Hirakata H, et al. Association between serum phosphate levels and stroke risk in patients undergoing hemodialysis: the Q‐cohort study. Stroke. 2016 Sep;47(9):2189–2196. https://doi.org/10.1161/STROKEAHA.116.013195
1. Fukagawa M, Yokoyama K, Koiwa F, Taniguchi M, Shoji T, Kazama JJ, et al. Clinical practice guideline for the management of chronic kidney disease‐mineral and bone disorder. Ther Apher Dial. 2013 Jun;17(3):247–288. https://doi.org/10.1111/1744-9987.12058
1. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan‐a web and mobile app for systematic reviews. Syst Rev. 2016 Dec;5(1):210. https://doi.org/10.1186/s13643-016-0384-4
1. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct;343:d5928. https://doi.org/10.1136/bmj.d5928

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[1] Shimamoto S, Yamada S, Hiyamuta H, Arase H, Taniguchi M, Tokumoto M, et al. Association of serum phosphate concentration with the incidence of intervention for peripheral artery disease in patients undergoing hemodialysis: 10‐year outcomes of the Q‐cohort study. Atherosclerosis. 2020 Jul;304:22–29. https://doi.org/10.1016/j.atherosclerosis.2020.04.022

[2] Shimamoto S, Yamada S, Hiyamuta H, Arase H, Taniguchi M, Tokumoto M, et al. Association of serum phosphate concentration with the incidence of intervention for peripheral artery disease in patients undergoing hemodialysis: 10‐year outcomes of the Q‐cohort study. Atherosclerosis. 2020 Jul;304:22–29. https://doi.org/10.1016/j.atherosclerosis.2020.04.022

[3] Yamada S, Tsuruya K, Taniguchi M, Tokumoto M, Fujisaki K, Hirakata H, et al. Association between serum phosphate levels and stroke risk in patients undergoing hemodialysis: the Q‐cohort study. Stroke. 2016 Sep;47(9):2189–2196. https://doi.org/10.1161/STROKEAHA.116.013195

[4] Yamada S, Tsuruya K, Taniguchi M, Tokumoto M, Fujisaki K, Hirakata H, et al. Association between serum phosphate levels and stroke risk in patients undergoing hemodialysis: the Q‐cohort study. Stroke. 2016 Sep;47(9):2189–2196. https://doi.org/10.1161/STROKEAHA.116.013195

[5] Fukagawa M, Yokoyama K, Koiwa F, Taniguchi M, Shoji T, Kazama JJ, et al. Clinical practice guideline for the management of chronic kidney disease‐mineral and bone disorder. Ther Apher Dial. 2013 Jun;17(3):247–288. https://doi.org/10.1111/1744-9987.12058

[6] Fukagawa M, Yokoyama K, Koiwa F, Taniguchi M, Shoji T, Kazama JJ, et al. Clinical practice guideline for the management of chronic kidney disease‐mineral and bone disorder. Ther Apher Dial. 2013 Jun;17(3):247–288. https://doi.org/10.1111/1744-9987.12058

[7] Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan‐a web and mobile app for systematic reviews. Syst Rev. 2016 Dec;5(1):210. https://doi.org/10.1186/s13643-016-0384-4

[8] Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan‐a web and mobile app for systematic reviews. Syst Rev. 2016 Dec;5(1):210. https://doi.org/10.1186/s13643-016-0384-4

[9] Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct;343:d5928. https://doi.org/10.1136/bmj.d5928

[10] Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011 Oct;343:d5928. https://doi.org/10.1136/bmj.d5928

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Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

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Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

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