Restoration of renal anemia following therapy with etelcalcetide for refractory secondary hyperparathyroidism: a case report with mini-review

The patient was a 72-year-old woman who had been under dialysis for a long time to chronic renal failure of unknown etiology. Her dialysis vintage was 22 years. She was under treatment with cinacalcet for secondary hyperparathyroidism (2HPT). However, cinacalcet was withdrawn because she presented digestive complications. In March 2017, treatment with etelcalcetide, a novel intravenous calcimimetic, became possible. On April 10, 2017, her intact parathyroid hormone (PTH) level was 1150 pg/mL, and etelcalcetide 5 mg was administrated three times per week after dialysis. After 6 months, her intact PTH (iPTH) level was 283 pg/mL and her hemoglobin (Hb) level was 12.9 g/dL though she was not administered erythropoietin-stimulating agent (ESA). She had three detectable parathyroid glands. Conventionally, her parathyroid glands should have been removed; however, as her parathyroid hormone level decreased, this procedure was not required. In this patient, etelcalcetide improved severe 2HPT and renal anemia.