Vitamin D and cinacalcet administration pre-transplantation predict XXXX post-transplantation: a case-control study of 355 deceased-donor renal transplant recipients over 3  years.

@entity1 @entity1391 @entity460 @entity2742 @entity461
BACKGROUND: The effects of pre-transplantation medication for secondary @entity2742 on post-transplantation @entity461 ( @entity461 ) and @entity460 levels have not yet been conclusively determined. Therefore, this study sought to determine the level of off-label use of cinacalcet and to determine predictors of its administration during the long-term follow-up of a cohort of individuals who received deceased-donor renal transplants. Furthermore, safety considerations concerning the off-label use of cinacalcet are addressed. METHODS: This was a case-control study of 355 stable renal transplant recipients. The @entity1 cohort was divided into two groups. Transplant group A comprised @entity1 who did not receive cinacalcet treatment, and transplant group B comprised @entity1 who received cinacalcet treatment during follow-up after renal transplantation. The characteristics of the @entity1 were evaluated to determine predictors of cinacalcet use after successful renal transplantation. RESULTS: Compared with the control individuals (n   =   300), the cinacalcet-treated individuals (n   =   55) had significantly higher @entity461 levels at 4  weeks post-transplantation (20.3        1.6 versus 40.7        4.0 pmol/L, p   =   0.0000) when they were drug naive. At 3.2  years post-transplantation, cinacalcet-treated @entity1 showed higher @entity461 (26.2        2.3 versus 18.4        2.3 pmol/L, p   =   0.0000), higher @entity460 (2.42        0.03 versus 2.33        0.01  mmol/L, p   =   0.0045) and lower @entity1391 (0.95        0.04 versus 1.06        0.17  mmol/L, p   =   0.0021) levels. Individuals in the verum group were more likely to receive cinacalcet therapy (45.5% versus 14.3%, p   =   0.0000), and they had higher pill burdens for the treatment of @entity2742 (1.40        0.08 versus 0.72        0.03 pills per @entity1 , p   =   0.0000) whilst they were on the waiting list for transplantation. Regression analysis confirmed the associations between @entity2742 and @entity461 levels at 4  weeks post-transplantation (p   =   0.0001), cinacalcet use (p   =   0.0000) and the preoperative total pill burden (p   =   0.0000). Renal function was the same in both groups. CONCLUSIONS: Parathyroid gland dysfunction pre-transplantation translates into clinically relevant @entity2742 post-transplantation, despite @entity1 being administered more intensive treatment whilst on dialysis. @entity461 levels at 4  weeks post-transplantation might serve as a marker for the occurrence of @entity2742 during follow-up.
