LAUSR

Calcimimetic agent is used for secondaryhyperparathyroidism (SHPT), but it might cause gastrointestinal side-effects. These side effects are severe problem for PD patients with gastrointestinal symptoms due to dialysis fluid storage. Evocalcet is a new calcimimetic agent for SHPT, and expected to reduce gastrointestinal related symptoms. There have been some reports about switching from cinacalcet to evocalcet or administered for HD patients. However, there have been few reports on PD patients. Here, we reported the efficiency and safety of evocalcet in PD patients. PD patients who had newly started to treat for SHPT with evocalcet, between August 2018 to August 2019 were selected. Patients who died or transferred to HD within 6 months after administered evocalcet were excluded. We compared the changes in whole PTH level, serum phosphorus level and serum corrected calcium level with baseline and after administration. Moreover, we investigated adverse events of gastrointestinal related symptoms. Overall, 34 PD patients were included, (mean age: 67.5 years old, male/female: 23/11, average PD vintage: 39.6 months, serum phosphorus level: 5.1 ± 1.0 mg/dl). There was a significant reduction in whole PTH at week 16 from baseline (346 ± 187 pg/ml vs 258 ± 196 pg/ml, p <0.001), and this relation was continued at week 32. There was no significant change in serum phosphorus level during this study. Serum corrected calcium level was the lowest at week 12 from baseline (9.4±0.7 mg/dl vs 9.0±0.1 mg/dl: p=0.004), thereafter, serum calcium level was not decline with adjustment of vitamin D receptor activators and calcium preparation. Adverse events were observed in 6 patients (18.2 %), nausea occurred in 3 patients, decreased appetite occurred in 2 patients, and diarrhea occurred in 2 patients. Although some adverse events had occurred, all patients continued study. These results suggested that evocalcet might be efficient and safety in PD patients with SHPT.