Effect of Cinacalcet on Cardiovascular Disease in Patients Undergoing Dialysis

In this trial, patients with secondary hyperparathyroidism who were undergoing dialysis were assigned to receive either the calcimimetic agent cinacalcet or placebo. Cinacalcet did not significantly reduce the risk of death or major cardiovascular events. Cardiovascular disease is very common among patients with chronic kidney disease, including those treated with hemodialysis, among whom the risk of death from cardiovascular disease is increased by a factor of 10 or more as compared with the risk in the general population. 1 , 2 Cardiovascular risk factors that have been linked to chronic kidney disease include heightened states of inflammation, 3 oxidative stress, 4 activation of the renin–angiotensin–aldosterone system 5 and the sympathetic nervous system, 6 endothelial dysfunction, 7 retention of uremic toxins promoting atherosclerosis and arteriosclerosis, 8 abnormalities in platelet aggregation, 9 anemia, 10 and disorders of bone and mineral metabolism, including hyperphosphatemia, hypercalcemia, and secondary hyperparathyroidism. . . .