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Kidney Week

Abstract: PO1245

The Use of Etelcalcetide in a Special Cohort of Home Hemodialysis Patients with Severe Secondary Hyperparathyroidism

Session Information

  • Home Hemodialysis
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Hemodialysis

Authors

  • Ewaida, Ahmed A.M., HHD Home Health Care, Al Ain, Abu Dhabi, United Arab Emirates
  • Bernieh, Bassam O., HHD Home Health Care, Al Ain, Abu Dhabi, United Arab Emirates
Background

Secondary hyperparathyroidism (sHPT), a is common complication of chronic kidney disease. Its clinical consequences include extraskeletal vascular and valvular calcifications, changes in bone metabolism resulting in renal osteodystrophy, and an increased risk of cardiovascular morbidity and mortality. Etelcalcetide is an intravenous calcimimetic that increases sensitivity of the calcium-sensing receptor to calcium and decreases PTH, so it’s indicated for the treatment of secondary hyperparathyroidism (SHPT) in dialysis patients. In this observational study we are reporting our experience in treating SHPT by Etelcalcetide, in a very special cohort of sick, highly co-morbid, bed, and home bound hemodialysis patients, at home with the assistance of a hemodialysis nurse, we called the program as Nurse Assisted Home Hemodialysis (NAHHD).

Methods

This is a retrospective observational sixth months study. Thirty home HD patients, managed by NAHHD program, were included in this study, average age 59.6 (26-87year, 60% female. Etiology of ESRD was DM in 63%, 53% of them have hypertension. Vascular access AVF & AVG 60%, CVC 37%. Average comorbidities 9.4 (6-16). Patients were either naïve (30%) or switched from cinacalcet to Etelcalcetide due to non-compliance 50%, PTH resistance 31%, and bad tolerance of Cinacalcet 19%.

Results

The medication was well tolerated, two patients had GI side effects (6.5%), only with high dose of Etelcalcitide. The results of treating secondary hyperparathyroidism by Etelcalcetide in a special cohort of the patients for 6 consecutive months are illustrated in the graph.

Conclusion

This study showed that Etelcalcetide is efficient and well tolerated in this special group of sick, highly comorbid, bed and home bound home hemodialysis patients. The drug was well tolerated with minimal GI side effects.

Funding

  • Government Support - Non-U.S.