Clinical value of serum iPTH, ALP and serum markers levels in patients with secondary hyperparathyroidism receiving paricalcitol combined with cinacalcet

Background: This study aimed to evaluate the effect of combining paricalcitol with cinacalcet on the levels of intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) in patients with secondary hyperparathyroidism undergoing maintenance hemodialysis (MHD). Methods: A retrospective analysis was conducted on the clinical records of 129 patients diagnosed with chronic kidney disease (CKD) and secondary hyperparathyroidism who received MHD between June and December 2022. The patients were categorised into three groups based on their treatment regimen: Group A (paricalcitol alone, n=43), Group B (cinacalcet alone, n=43), and Group C (combined paricalcitol and cinacalcet, n=43). Hemoglobin (Hb), serum albumin (Alb), calcium (Ca), phosphorus (P), iPTH, ALP, serum creatinine (Scr), and blood urea nitrogen (BUN) levels were measured at admission, 1 day, 3 months, and 6 months to compare the outcomes across the three groups. Results: No significant differences among the groups were observed in Hb and Alb levels at 1 day post-admission (P>0.05). However, after 3 and 6 months of treatment, Hb and Alb levels increased in all groups, with Group C showing the greatest improvement (P<0.05). iPTH, Ca, and P levels were similar across all groups on day 1 (P>0.05), but by 3 and 6 months, all groups showed reductions, with Group C having the lowest levels (P<0.05). Similarly, ALP, Scr, and BUN levels decreased in all groups over time, with Group C again demonstrating the greatest reduction (P<0.05). Conclusions: The combination of paricalcitol and cinacalcet was effective in reducing iPTH, calcium, phosphorus, and ALP and improving Hb and Alb levels in patients with secondary hyperparathyroidism on maintenance hemodialysis. This treatment approach offers significant benefits in managing SHPT.