Impact of Pre-Kidney Transplant Cinacalcet Use on Post-Transplant Outcomes
L. Bowman1, S. Lloyd2, J. Buggs1, H. Pearson1, R. Baliga3, E. Rogers1, A. Kumar4
1Tampa General Hospital, Tampa, FL, 2University of Florida, Gainesville, FL, 3Florida Kidney Physicians, Tampa, FL, 4University of South Florida, Tampa, FL
Meeting: 2019 American Transplant Congress
Abstract number: C192
Keywords: Hyperparathyroidism, Kidney transplantation, Post-operative complications
Session Information
Session Name: Poster Session C: Kidney: Cardiovascular and Metabolic
Session Type: Poster Session
Date: Monday, June 3, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Pre-kidney transplant (KT) cinacalcet use is a predictor of persistent post-transplant hyperparathyroidism (HPT), often necessitating post-KT parathyroidectomy (PTX) or cinacalcet reinitiation, both of which have significant disadvantages. The purpose of this study was to compare post-transplant outcomes associated with pre-KT daily cinacalcet use of <30mg vs. >30mg.
*Methods: We conducted a retrospective cohort study of adult (> 18 years) KT patients from 1/1/2012-12/31/2016 prescribed cinacalcet pre-KT. Death at last follow-up and multi-organ transplants were excluded. Post-transplant PTX, cinacalcet reinitiation, and complications were compared based on pre-KT daily cinacalcet dose. Differences across compared groups for continuous variables were assessed using the independent sample t-test and for binary variables using the chi-square test. All p-values were 2-sided and <0.05 was considered to be statistically significant.
*Results: Of the 928 kidney transplant performed, 227 patients (111 in ≤30mg daily vs. 116 in >30mg daily group) met inclusion. Reinitiation of cinacalcet occurred in 69% of the >30mg group vs 41% of the ≤30mg group (p<0.001). The reinitaiton dose was significantly greater in the >30 mg daily cinacalcet group (p<0.001). Pre-KT daily cinacalcet use >30mg resulted in post-KT PTX at more than double the rate of patients with ≤30mg daily pre-KT use (p=0.021). Post-KT bone complications were also significantly greater in the >30mg daily group (p=0.040).
*Conclusions: Pre-KT daily cinacalcet doses >30mg was associated with post-KT cinacalcet reinitiation, PTX, and the development of bone disease. These results should be considered when evaluating KT candidates maintained on higher pre-KT cinacalcet doses to evaluate need for pre-KT PTX.
To cite this abstract in AMA style:
Bowman L, Lloyd S, Buggs J, Pearson H, Baliga R, Rogers E, Kumar A. Impact of Pre-Kidney Transplant Cinacalcet Use on Post-Transplant Outcomes [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-pre-kidney-transplant-cinacalcet-use-on-post-transplant-outcomes/. Accessed December 12, 2024.« Back to 2019 American Transplant Congress