Authors: Diah Sri Ekawati1, Didik Hasmono2
Departement of Clinical Pharmacy, Faculty of Pharmacy,
Airlangga University Dharmawangsa Dalam, Surabaya, Indonesia
Email: diahsrie@gmail.com
Abstract
Chronic kidney disease (CKD) describes the abnormalities of kidney structure or function, present for more than 3 months. Seconday hiperparathyroid (SHPT) is one of clinical manifestation of CKD. SHPT characterized by excessive secretion of parathyroid hormone (PTH) and a combination of vitamin D deficiency, phosphate retention, high FGF23 and decreased total serum levels of 1,25-dihydroxy vitamin D and calcium. SHPT with high levels of calcium and phosphate causes renal osteodystrophy, erythropoietin resistance, vascular calcification, and left ventricular hypertrophy. Etelcalcetide is a novel calcimimetic agent that suppresses the secretion of PTH by binding to and activating the calcium-sensing receptor on the parathyroid gland. Etelcalcetide indicated for the treatment of SHPT with CKD on hemodialysis. The treatment is given by intravenous (IV) bolus injection three times per week at the end of each dialysis session. FDA approved on february 2017 for SHPT in adults with chronic kidney disease on hemodialysis. Etelcalcetide be the first calcimimetic agent that can be administered intravenously. Adverse event occuring among 5% or more of patient treated with etelcalcetide included nausea, vomiting, hypocalcemia. Among patients receiving hemodialysis with moderate to severe SHPT, the use of etelcalcetide was not inferior to cinacalcet in reducing serum PTH concentrations over 26 weeks. Further studies are needed to assess clinical outcomes as well as longer-term efficacy and safety. In this study, we aimed to review the use of Etelcalcetide in patients with SHPT in CKD.
Keywords: Calcimimetic, Cronic Kidney Disease, Etelcalcetide, Secondary Hyperparathyroid
