Rx May Boost Bone Strength in Kidney Patients

Cinacalcet may prevent hip fractures in dialysis patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Some dialysis patients taking a medication called cinacalcet just can't catch a break — and that's a good thing.

Dialysis can cause bone thinning and increase the risk of fractures. A new study found that cinacalcet (Sensipar) reduced hip fracture rates in dialysis patients.

Because a hip fracture can be life-threatening, anything that strengthens the bones is good news, the authors of this study said.

“Given the high mortality, increased hospitalization rates, and costs associated with fractures, our study suggests that a reduction in fractures could have important personal health and societal financial benefits,” the authors, led by Sharon M. Moe, MD, of the Indiana University School of Medicine in Indianapolis, wrote.

People who develop kidney failure often need to go on dialysis, a complex procedure that clears the body of waste material — which is a function of healthy kidneys. A condition called secondary hyperparathyroidism is common in people who have kidney failure. The parathyroid glands affect calcium absorption and metabolism. Secondary hyperparathyroidism can cause bone thinning, or osteoporosis, which can lead to fractures.

Although treatments for osteoporosis exist, they are not often effective in patients who have renal failure. In some cases, doctors say kidney failure patients should not receive osteoporosis treatments. No medications have been approved to treat dialysis patients for osteoporosis.

Dr. Moe and team used data from a past study on cinacalcet. The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events, or EVOLVE, trial followed 3,883 patients for 64 months.

The patients received either cinacalcet or a placebo. In the placebo group, 255 of 1,935 patients had hip fractures. In the cinacalcet group, 238 of 1,948 patients had hip fractures. The initial data did not seem to show an effect from cinacalcet.

Dr. Moe and colleagues then adjusted for other factors like patients' other health conditions and whether multiple fractures occurred. The adjusted results found that cinacalcet reduced fracture rates by 16 to 29 percent in patients on dialysis.

This study was published Dec. 11 in the Journal of The American Society of Nephrology.

All of the authors received grants, speaking fees or other payments from companies like Abbott, Baxter, Home Dialysis Plus and Johnson & Johnson. These companies make medications, equipment or devices used in treating osteoporosis or kidney failure. Study authors Drs. Bastian Dehmel and William G. Goodman work for and own stock in Amgen, which manufactures Sensipar.

Review Date: 
December 9, 2014
Last Updated:
December 14, 2014