Efficacy And Safety Of Cinacalcet In Dialysis CKD Patients With Secondary Hyperparathyroidism:a Meta-Analysis

Backgroud Cinacalcet is a new drug to therapy secondary hyperparathyroidism in people with chronic kidney disease (CKD), use a system review and meta-analysis to identify the safety and efficacy of cinacalcet.Methods Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE were searched for randomized controlled trials (RCTs) of using cinacalcet to therapy secondary hyperparathyroidism in people with CKD, treatment group got therapy of cinacalcet plas cenventional therapy, including vitamin D analogs and(or) phosphate binders, and the control group got therapy of placebo with conventional therapy or only conventional therapy.Results14studies (7200dialysis patients) in15papers were identified, the end of treatment of PTH (MD-285.89pg/ml,95%CI-341.27to-230.51), serum calcium (MD-0.82mg/dl,95%CI-0.94to-0.70), serum phosphorus (MD-0.39mg/dl,95%CI-0.54to-0.25]) and calcium-phosphorus product(MD-8.99mg2/d12[95%CI-10.37,-7.61]) were significantly lower than control group. But cinacalcet has an uncertain effect on bone metabolism, and did not reduce the overall mortality (RR0.97,95%CI0.89to1.05) in patients. Compared with control groups, patients treated with cinacalcet got more hypocalcaemia (RR7.34,95%CI5.38to10.03), nausea(RR1.83,95%CI1.65to2.03), emesis(RR1.89,95%CI1.68to2.12) and upper respiratory infection(RR1.51,95%CI1.08to2.10)Conclusions Treatment of cinacalcet could effectively improve serum biochemical indexes in people with secondary hyperparathyroidism within CKD, but did not reduce the overall mortality.