Abstract: Abstract:Objective To evaluate the efficacy and safety of cinacalcet on secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). Methods Patients with ESRD and SHPT for the treatment with calcimimeticagents were included in this study. MEDLINE (1996.1- 2014.9), OVID (1963.1- 2014.9), Chinese Wanfang database (1996.1- 2014.9), CNKI (1996.1- 2014.9) and the clinical control test database of Cochrane Library were searched． Related literature, including published or unpublished papers, and meeting procedding were hand- searched. Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was conducted by RevMan 5.2. Results Nineteen randomized controlled trials involving 7 702 patients were included. The meta- analysis showed that compared with conventional therapy，cinacalcet can significantly decrease serum parathyroid hormone in dialysis patients [WMD=-301.54 µg/L, 95%CI:(-344.38)-(-258.7）µg/L, P＜0.05], decrease serum level of calcium [WMD=-8.3 mg/L, 95%CI: (-9.1） -（-7.4）mg/L, P＜0.05], and decrease serum level of phosphorus [WMD=-3.4 mg/L, 95%CI :(-4.6)- (-2.3) mg/L, P＜0.05]. The total incidence of adverse events was similar (RR=1.03, 95%CI:0.98-1.09, P＞0.05） . Cinacalcet increased nausea (RR =2.05, 95%CI :1.53- 2.75, P＜0.05） , vomiting (RR =2.00, 95%CI:1.78- 2.23, P＜0.05） , diarrhea (RR =1.15, 95%CI:1.03-1.30, P＜0.05） , and asymptomatic hypocalcaemia (RR =7.60, 95%CI :5.61-10.30, P＜0.05） , but they were usually transient, and mild to moderate in severity. The mortality was similar (RR =0.97, 95%CI: 0.89-1.05, P＞ 0.05） . Conclusion Results confirm that cinacalcet suppresses parathyroid hormone and decreases calcium and phosphorus in secondary hyperparathyroidism patients receiving dialysis. Cinacalcet increases risks of nausea, vomiting, diarrhea and hypocalcaemia,without increasing mortality.

Key words: receptors, calcium-sensing, enal dialysis, yperparathyroidism, secondary, eta-analysis, inacalcet, cal? cimimetic, nd-stage renal disease