西那卡塞对甲状旁腺功能亢进肾移植患者高钙血症的影响:系统综述和荟萃分析

IF 0.2 Q4 UROLOGY & NEPHROLOGY
Hanie Fooladi, Fatemeh Vashahi Torfi, Ali Khodaparast, Sara Abbasian, N. Alivand, Mohamad Khaledi, Soleyman Alivand, Farshad Gharebakhshi, Moein Shakerian
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Moreover, PRISMA was used for qualitatively evaluating the studies since the study protocol was registered on the PROSPERO website. In addition, data analysis was conducted using Stata version 14, and the significance level was set at 0.05. Results: The present meta-analysis included 26 studies (24 cohort studies and two randomized clinical trials) investigating 602 patients with renal transplantation and hyperparathyroidism. According to our findings, cinacalcet reduced the serum calcium (MD: -2.24, 95% CI: -2.82, -1.67), parathormone (SMD: -0.85, 95% CI: -1.15, -0.54), and alkaline phosphatase levels (SMD: -0.45, 95% CI: -0.91, -0.01). Moreover, 30-60 mg of cinacalcet per day effectively treated hypercalcemia (SMD: -2.77, 95% CI: -3.57, -1.98), while other doses were not significantly effective. 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引用次数: 0

摘要

引言:肾移植后,终末期肾病患者会出现甲状旁腺功能障碍和电解质异常,包括钙和磷酸盐水平。然而,西那卡切是治疗高钙血症最常用的药物之一。因此,本系统综述和荟萃分析旨在研究西那钙给药对肾移植患者高钙血症的影响。材料和方法:使用经验证的关键词搜索Cochrane、Web of Science、Scopus和PubMed的在线数据库,直到2023年4月。此外,由于研究方案已在PROSPERO网站上注册,因此PRISMA用于对研究进行定性评估。此外,使用Stata版本14进行数据分析,显著性水平设置为0.05。结果:本荟萃分析包括26项研究(24项队列研究和两项随机临床试验),调查602名肾移植和甲状旁腺功能亢进患者。根据我们的研究结果,西那卡塞降低了血清钙(MD:-2.24,95%CI:-2.82,-1.67)、甲状旁腺激素(SMD:-0.85,95%CI:-1.15,-0.54)和碱性磷酸酶水平(SMD:-0.55,95%CI:-0.91,-0.01)。此外,每天30-60 mg西那卡塞特有效治疗高钙血症(SMD:-2.77,95%CI:-3.57,-1.98),而其他剂量则没有显著效果。此外,对使用该药物少于6个月(SMD:-2.55,95%CI:-4.25,-0.86)、12-18个月(SMD:-2.60,95%CI:-3.53,-1.67)和超过24个月(tmd:-1.71,95%CI:-2.54,-0.88)的患者进行了西那卡司的疗效研究。最后,cinacalcet对60~64岁肾移植患者的疗效最高(SMD:-3.59,95%CI:5.14,-2.04)。此外,西那卡塞的作用与患者的年龄有直接而积极的关系。注册:本研究基于PRISMA检查表编制,其方案已在PROSPERO(ID:CRD42023428620)和研究注册处(UIN:reviewregistry1667)网站上注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of cinacalcet on hypercalcemia in kidney transplant patients with hyperparathyroidism: systematic review and meta-analysis
Introduction: Following renal transplantation, patients with end-stage renal disease develop parathyroid dysfunction and electrolyte abnormalities, including calcium and phosphate levels. However, cinacalcet is one of the most used medications for hypercalcemia. Therefore, the present systematic review and meta-analysis aimed to investigate the effect of cinacalcet administration on hypercalcemia in patients with renal transplantation. Materials and Methods: The online databases of Cochrane, Web of Science, Scopus, and PubMed were searched until April 2023 using validated keywords. Moreover, PRISMA was used for qualitatively evaluating the studies since the study protocol was registered on the PROSPERO website. In addition, data analysis was conducted using Stata version 14, and the significance level was set at 0.05. Results: The present meta-analysis included 26 studies (24 cohort studies and two randomized clinical trials) investigating 602 patients with renal transplantation and hyperparathyroidism. According to our findings, cinacalcet reduced the serum calcium (MD: -2.24, 95% CI: -2.82, -1.67), parathormone (SMD: -0.85, 95% CI: -1.15, -0.54), and alkaline phosphatase levels (SMD: -0.45, 95% CI: -0.91, -0.01). Moreover, 30-60 mg of cinacalcet per day effectively treated hypercalcemia (SMD: -2.77, 95% CI: -3.57, -1.98), while other doses were not significantly effective. Furthermore, the effect of cinacalcet was investigated in patients using the medication for less than six months (SMD: -2.55, 95% CI: -4.25, -0.86), 12-18 months (SMD: -2.60, 95% CI: -3.53, -1.67), and more than 24 months (SMD: -1.71, 95% CI: -2.54, -0.88). Finally, the effect of cinacalcet was the highest in the patients who were 60-64 years old compared to other age groups (SMD: -3.59, 95% CI: -5.14, -2.04). Conclusion: Cinacalcet could improve hypercalcemia and hyperparathyroidism in patients with renal transplantation. Moreover, the effect of cinacalcet had a direct and positive relationship with the patient’s age. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42023428620) and Research Registry (UIN: reviewregistry1667) website.
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来源期刊
Journal of Renal Injury Prevention
Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-
CiteScore
1.60
自引率
0.00%
发文量
36
期刊介绍: The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.
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