Impact of cinacalcet pre-transplantation on mineral metabolism in renal transplant recipients

Aim Cinacalcet is effective in reducing parathyroid hormone (PTH) in patients on dialysis. Reports of biochemical profiles and other clinical outcomes in patients discontinuing cinacalcet at time of renal transplantation are limited. Methods A retrospective study assessing markers of mineral metabolism, graft and patient outcomes in renal transplant recipients to determine differences in patients discontinuing cinacalcet (C+) compared with patients not treated with cinacalcet (C−) at time of transplantation. To allow for differences between groups in pre-transplant biochemical parameters, we also analysed a matched cohort of C− with C+ recipients (2:1), matched for age, calcium and PTH levels at transplantation. Results Five hundred thirty-two recipients (460 C−, 72 C+), transplanted January 2006–December 2012, were analysed, mean age 48.0 ± 12.7 years and 64.3% were men. At a median 42.9 months follow up, there were 10 deaths (1.9%), 56 allograft loss (10.6%) and 5 parathyroidectomies post-transplant (0.8%). Median PTH immediately pre-transplant was higher in C+ versus C− (50.7(25.4–75.2) versus 28.3(13.9–49.7) pmol/L, P