Calcitriol Versus Calcitriol and Low Dose Cinacalcet for TreatingSevere Secondary Hyperparathyroidism in Hemodialysis Patients: ARandomized Clinical Trial

Background: secondary hyperparathyroidism is prevalent among hemodialysis patients associated with vascular and skeletalcomplications. thus, treatment is required, specially before kidney transplantation.objectives: this study aimed to compare the efficacy of calcitriol and cinacalcet versus standard-dose calcitriol in treating severesecondary hyperparathyroidism in hemodialysis patients.methods: this randomized clinical trial was conducted on 70 hemodialysis patients with severe secondary hyperparathyroidismwho were randomly allocated to two intervention groups. group a received calcitriol 1mg po every other night, and group b tookcalcitriol 1mg po every other night and cinacalcet 30mg po daily. the improvement of laboratory parameters was investigated 3 and6 months after the intervention.results: there was no significant difference between the two groups regarding age, sex, body mass index, and duration of dialysis(p > 0.05). in group a, serum levels of calcium (p < 0.001) and parathyroid hormone (pth) (p < 0.001) were significantly reducedcomparedto baseline. however, phosphorus (p=0.175)andalbumin (p=0.143)serumlevelsshowednosignificant changes. in groupb, calcium (p = 0.001), pth (p < 0.001), and serum phosphorus (p < 0.001) levels were significantly decreased after the intervention.nevertheless, serum albumin levels showed no significant changes from baseline (p = 0.061). changes in serum phosphorus (p <0.001) and pth levels (p < 0.001) were significantly different between the groups. however, changes in serum calcium (p = 0.062)and albumin levels (p = 0.773) were not significantly different (wilcoxon signed-rank test).conclusions: the results of this study showed that treatment with cinacalcet and calcitriol was more effective than calcitriol alonewithout any side effects.