Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation

Introduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patie...

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Authors: Delaey, Philippe, Devresse, Arnaud, Morelle, Johann, Faitatzidou, Danai, Iriarte, Miren, Kanaan, Nada, Buemi, Antoine, Mourad, Michel, Darius, Tom, Goffin, Eric, Jadoul, Michel, Labriola, Laura, CUSL Kidney Transplantation Network Collaborators
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/70813
Online Access:http://hdl.handle.net/10230/70813
http://dx.doi.org/10.1016/j.ekir.2024.04.004
Access Level:Open access
Keyword:Chronic hemodialysis
Etelcalcetide
Hyperparathyroidism
Kidney transplantation
Mineral metabolism
Parathyroidectomy
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spelling Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantationDelaey, PhilippeDevresse, ArnaudMorelle, JohannFaitatzidou, DanaiIriarte, MirenKanaan, NadaBuemi, AntoineMourad, MichelDarius, TomGoffin, EricJadoul, MichelLabriola, LauraCUSL Kidney Transplantation Network CollaboratorsChronic hemodialysisEtelcalcetideHyperparathyroidismKidney transplantationMineral metabolismParathyroidectomyIntroduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patients on HD meeting predefined criteria who received a kidney transplant at our institution between January 1, 2015, and December 12, 2022. The incidence of parathyroidectomy and the evolution of calcium, phosphate, and intact parathyroid hormone (iPTH) levels after transplantation was analyzed according to the type of calcimimetic treatment before transplantation (cinacalcet vs. etelcalcetide vs. none). Results: Overall, 372 patients (aged 53 years; interquartile range [IQR]: 42-62 years) were included. At the time of transplantation, 35, 75, and 262 patients were under etelcalcetide, cinacalcet, or no calcimimetic, respectively. After 1064 (IQR: 367-1658) days, the incidences of parathyroidectomy in the etelcalcetide, cinacalcet, no calcimimetic groups were 29%, 12%, and 1%, respectively (P < 0.001). Etelcalcetide was associated with an increased incidence of parathyroidectomy after adjustment for age, sex, and HD vintage (hazard ratio [HR]: 97.0, 95% confidence interval [CI]: 19.1-493.9, P < 0.001). The incidence of parathyroidectomy was related to etelcalcetide dosage (6/11 [54.6%] in patients with ≥ 10 mg vs. 4/24 [16.7%] in patients with < 10 mg, P = 0.02). Moreover, peak calcium levels were higher (P < 0.001) and parathyroidectomy was performed earlier (median 80 vs. 480 days, P < 0.001) in the etelcalcetide compared with the cinacalcet group. Long-term graft function, graft loss, and mortality were similar. Conclusion: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic.Elsevier202520252024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/70813http://dx.doi.org/10.1016/j.ekir.2024.04.004reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésKidney Int Rep. 2024 Apr 4;9(7):2146-56© 2024 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/708132026-06-12T07:21:37Z
dc.title.none.fl_str_mv Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
title Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
spellingShingle Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
Delaey, Philippe
Chronic hemodialysis
Etelcalcetide
Hyperparathyroidism
Kidney transplantation
Mineral metabolism
Parathyroidectomy
title_short Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
title_full Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
title_fullStr Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
title_full_unstemmed Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
title_sort Etelcalcetide use during maintenance hemodialysis and incidence of parathyroidectomy after kidney transplantation
dc.creator.none.fl_str_mv Delaey, Philippe
Devresse, Arnaud
Morelle, Johann
Faitatzidou, Danai
Iriarte, Miren
Kanaan, Nada
Buemi, Antoine
Mourad, Michel
Darius, Tom
Goffin, Eric
Jadoul, Michel
Labriola, Laura
CUSL Kidney Transplantation Network Collaborators
author Delaey, Philippe
author_facet Delaey, Philippe
Devresse, Arnaud
Morelle, Johann
Faitatzidou, Danai
Iriarte, Miren
Kanaan, Nada
Buemi, Antoine
Mourad, Michel
Darius, Tom
Goffin, Eric
Jadoul, Michel
Labriola, Laura
CUSL Kidney Transplantation Network Collaborators
author_role author
author2 Devresse, Arnaud
Morelle, Johann
Faitatzidou, Danai
Iriarte, Miren
Kanaan, Nada
Buemi, Antoine
Mourad, Michel
Darius, Tom
Goffin, Eric
Jadoul, Michel
Labriola, Laura
CUSL Kidney Transplantation Network Collaborators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Chronic hemodialysis
Etelcalcetide
Hyperparathyroidism
Kidney transplantation
Mineral metabolism
Parathyroidectomy
topic Chronic hemodialysis
Etelcalcetide
Hyperparathyroidism
Kidney transplantation
Mineral metabolism
Parathyroidectomy
description Introduction: Etelcalcetide is an i.v. calcimimetic agent, effectively reducing parathyroid hormone levels in patients on maintenance hemodialysis (HD). The clinical impact of discontinuing etelcalcetide at the time of kidney transplantation is unknown. Methods: We retrospectively reviewed all patients on HD meeting predefined criteria who received a kidney transplant at our institution between January 1, 2015, and December 12, 2022. The incidence of parathyroidectomy and the evolution of calcium, phosphate, and intact parathyroid hormone (iPTH) levels after transplantation was analyzed according to the type of calcimimetic treatment before transplantation (cinacalcet vs. etelcalcetide vs. none). Results: Overall, 372 patients (aged 53 years; interquartile range [IQR]: 42-62 years) were included. At the time of transplantation, 35, 75, and 262 patients were under etelcalcetide, cinacalcet, or no calcimimetic, respectively. After 1064 (IQR: 367-1658) days, the incidences of parathyroidectomy in the etelcalcetide, cinacalcet, no calcimimetic groups were 29%, 12%, and 1%, respectively (P < 0.001). Etelcalcetide was associated with an increased incidence of parathyroidectomy after adjustment for age, sex, and HD vintage (hazard ratio [HR]: 97.0, 95% confidence interval [CI]: 19.1-493.9, P < 0.001). The incidence of parathyroidectomy was related to etelcalcetide dosage (6/11 [54.6%] in patients with ≥ 10 mg vs. 4/24 [16.7%] in patients with < 10 mg, P = 0.02). Moreover, peak calcium levels were higher (P < 0.001) and parathyroidectomy was performed earlier (median 80 vs. 480 days, P < 0.001) in the etelcalcetide compared with the cinacalcet group. Long-term graft function, graft loss, and mortality were similar. Conclusion: Etelcalcetide use during maintenance HD is associated with an increased incidence of early parathyroidectomy after transplantation compared to cinacalcet or no calcimimetic.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/70813
http://dx.doi.org/10.1016/j.ekir.2024.04.004
url http://hdl.handle.net/10230/70813
http://dx.doi.org/10.1016/j.ekir.2024.04.004
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Kidney Int Rep. 2024 Apr 4;9(7):2146-56
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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