Cinacalcet is not generally recommended for treating people on dialysis who have hyperparathyroidism because of their kidney disease. However, it is recommended for people on dialysis who:
- have very high levels of parathyroid hormone in their blood that can't be lowered by other treatments, and
- cannot have an operation to remove the parathyroid glands (a parathyroidectomy), because of the risks involved.
People who do receive cinacalcet should have regular checks. Treatment should be stopped if the parathyroid hormone levels in their blood do not fall substantially within 4 months.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.