Abstract: bjective  To evaluate the long-term efficacy of cinacalcet in hemodialysis patients with different levels of intact parathyroid hormone (iPTH) and secondary hyperparathyroidism (SHPT), so as to provide the information for clinical treatment of hemodialysis patients with SHPT.  Methods  A total of 47 SHPT patients treated during May 2010 to August 2019 online by Dr. Zhang Ling on “Well-known Doctor Online” as well as in the Hemodialysis Center, Department of Nephrology, Beijing Chuiyangliu Hospital were retrospectively analyzed. According to the baseline iPTH value, they were divided into two groups: <800pg/ml (group A) and ≥800pg/ml (group B). After cinacalcet therapy for 12 months, differences in serum calcium, phosphorus and iPTH were analyzed between the two groups. A decrease of iPTH ≥50% was defined as significant effective, and a decrease of iPTH≥30% was defined as effective.  Results  There were no differences in baseline indicators except iPTH level and the number of enlarged parathyroid glands by ultrasound examination between the two groups. Along with the cinacalcet treatment time, the compliance rate of serum calcium was higher in group A than in group B at the 6th month of the treatment (χ2=3.632, P=0.029) and had no difference between the two groups at the 12th month of the treatment (χ2=1.362, P=0.243); the compliance rate of serum phosphorus increased gradually, but had no statistical difference between the two groups at the 6th month and 12th month of the treatment (χ2=5.158 and 6.000, respectively; P=0.076 and 0.050, respectively); the mean iPTH value decreased significantly in both groups at the 6th month and 12th month of the treatment (Z=-2.728 and -1.852, respectively; P=0.003, 0.032), and there were no statistical differences in significant effective rate and effective rate between the two groups at the 6th month and 12th month of the treatment (χ2=0.011, 0.084, 0.869 and 0.254, respectively; P=0.917, 0.772, 0.351 and 0.614, respectively). The rate of iPTH decreased to ≤250pg/ml was higher in group A than in group B at the 6th month of the treatment (χ2=5.887, P=0.015) but had no difference between the two groups at the 12th month of the treatment (χ2=0.510, P=0.475).  Conclusion  Cinacalcet was effective in hemodialysis patients with different iPTH levels. The patients with iPTH <800pg/ml were more likely to reach the compliance level. Those with iPTH≥800pg/ml could also reach the compliance level with the extension of treatment course, suggesting that long-term use of cinacalcet can be beneficial even if parathyroid surgery was not available

Key words: Maintenance hemodialysis, Secondary hyperparathyroidism, Cinacalcet