A patient undergoing chronic dialysis whose renal anemia was successfully corrected by treatment with cinacalcet

A 62-year-old female dialysis patient with chronic glomerulonephritis had been receiving hemodialysis therapy for 32 years. In 1985 she underwent a parathyroidectomy for secondary hyperparathyroidism (HPT); however, her parathyroid hormone (PTH) levels gradually increased. Her serum calcium level ranged from 9.0 to 10.0 mg/dL, which caused difficulties in performing vitamin D injection therapy. No parathyroid glands were seen by echography or scintigraphy. On 31 March 2008 her intact PTH (iPTH) level was 895 pg/mL so treatment with cinacalcet 25 mg/day was started. After 3 months her iPTH level decreased to 269 pg/mL and her hemoglobin level increased from 9.3 to 12.9 g/dL. In some cases of severe HPT, anemia improves after parathyroidectomy; however, in this case, cinacalcet improved not only secondary HPT but also anemia.