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To investigate the clinical effect of cinacalcet in the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing hemodialysis for chronic kidney disease (CKD).
Patients who underwent hemodialysis for CKD and had SHPT were divided into the control group and the treatment group according to the cohort method. The control group was treated with 0.25 μg of calcitriol capsules once a day via oral administration. On this basis, the treatment group was treated with 25 mg of cinacalcet tablets once a day via oral administration. Patients in both groups were treated for 12 weeks. Clinical efficacy, parathyroid volume, parathyroid function [serum phosphorus, serum calcium, alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH)], and cardiovascular function [creatine kinase-MB (CK-MB), hypersensitive troponin Ⅰ (hs-cTnⅠ) and myoglobin (MYO)]were compared between the two groups. Safety was evaluated.
Sixty-two cases were enrolled in the treatment group and fifty-eight cases in the control group. After treatment, the total effective rates in the treatment group and the control group were 93.55% (58 cases/62 cases) and 77.59% (45 cases/58 cases), with statistically significant difference (P<0.05). After treatment, serum phosphorus levels in the treatment group and the control group were (1.31±0.16) and (1.50±0.34) mmol·L-1; serum calcium levels were (2.63±0.91) and (2.25±0.72) mmol·L-1; ALP levels were (83.28±8.40) and (126.46±12.39) U·L-1; iPTH levels were (215.32±16.69) and (307.65±20.14) pg·mL-1. The differences were statistically significant (all P<0.05). After treatment, the length of the parathyroid gland in the treatment group and the control group were (0.58±0.10) and (0.77±0.19) cm; width were (0.34±0.08) and (0.45±0.16) cm; thickness were (0.25±0.05) and (0.33±0.15) cm; volume were (0.82±0.15) and (1.13±0.22) cm3. The differences were statistically significant (all P<0.05). After treatment, serum CK-MB levels in the treatment group and the control group were (4.18±0.73) and (6.53±1.26) ng·mL-1; hs-cTnⅠ levels were (0.04±0.01) and (0.07±0.03) ng·mL-1; MYO levels were (70.69±9.41) and (112.39±12.60) ng·mL-1. The differences were statistically significant (all P<0.05). The adverse drug reactions in the treatment group and the control group mainly included nausea and vomiting, increased blood pressure, and myalgia. The total incidence of adverse drug reactions in the treatment group and the control group were 8.06 % (5 cases / 62 cases) and 22.41% (13 cases / 58 cases), respectively, and the difference was statistically significant (P<0.05).
Cinacalcet is effective in the treatment of SHPT in patients undergoing hemodialysis for CKD. It can reduce parathyroid gland volume, maintain calcium and phosphorus metabolism, and protect cardiovascular function, with high safety.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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