Cinacalcet/Sensipar

[KICKSTART]

Could someone please tell me what the usual is when on this, for checking your bloods (calcium levels & PTH) I understand they can change rapidly. So far ive been told bloods are weekly/monthly or 3 monthly !!!! We have monthly bloods as routine but PTH is only checked every 3 months.

[murf]

My GP (who I think is quite wonderful) has insisted on monthly PTH blood test above and beyond the normal three monthly test.

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[RichardMEL]

I used to get PTH monthly yet when I talked about it with my neph (who is also the prof of medicine) he said that doing PTH too often can lead to jumping the gun on what the trend is - so who really knows. I did it monthly anyway because I liked to see any trend forming. Sensipar tends to lower Calcium levels, so you do need to keep an eye on that. It also, helpfully, lowers cholesterol!

[del]

When hubby first started sensipar he had to have PTH checked every couple of weeks.  Now it is monthly.  He started sensipar about 5 or 6 months ago. His PTH was over 1300 at the time and last month it was 696!!!  Had it tested again yesterday but won't get the results until next week. He has not had any side effects from it at all. He takes it with his meals.

[MooseMom]

Do all dialysis patients have high PTH levels?

[BigSky]

Here the tests were monthly while adjusting the initial dosage of sensipar and calcijex  once the desired range was achieved the tests went to every 3 months.

However since medicare bundling came down, we are still on sensipar but have been switched to oral vit d now and tests are the beginning of the quarter with no tests to see if its effective or not until the next quarterly test.  Also PTH was to be under 300 because of medical evidence, now medicare says it only has to be under 600.

[RightSide]

I used to get PTH monthly yet when I talked about it with my neph (who is also the prof of medicine) he said that doing PTH too often can lead to jumping the gun on what the trend is - so who really knows.

I always wondered why doctors don't capitalize on all the mathematical techniques that investors use to follow trends in stock prices and economic changes.  Doctors seem to have reinvented the wheel--and the algorithms that doctors use are far less sophisticated than the ones that investors use.

Here's a simple thing I did right off the bat:

I put the monthly PTH values into an Excel spreadsheet and computed an exponential moving average.  Then I charted the PTH and moving average on ths same axes.  Every time the PTH trend line broke above or below the moving average line by more than 10%, it sure looked to me like time to adjust the dosages of my meds.  This simple technique did a better job of anticipating when to adjust the dosages than the dumb algorithm the doctors use, which is too prone to wild swings in PTH and med dosages.

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Rightside ....ok now let us have it in plain english   

[Zach]

My center first did PTH levels quarterly, now it's monthly.
We'll see if that changes as the CMS bundle comes more into play.

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Had to insist they check my PTH today as this is getting ridiculous also they are going to let me run out of Cinacalcet despite my giving them 2 weeks notice to order it for me . I dont know what difference it will make but i will be several days without it now , that cant be right.

[billybags]

Al's PTH has risen in the last 3 months. I ask nurse to do a PTH blood test last week when she did the monthly bloods. I was told that they only do it every 6 months, so got another 3 months to wait. Hello are they bothered.

[RichardMEL]

Al's PTH has risen in the last 3 months. I ask nurse to do a PTH blood test last week when she did the monthly bloods. I was told that they only do it every 6 months, so got another 3 months to wait. Hello are they bothered.

I would get the neph to order one. If they're too stupid to noitice an upward trend in PTH values and understand that this is potentially damaging I wouldn't accept that. It's your body and in six months your PTH could be off the scale and causing real bone damage!!