Cinacalcet HCL

• Common name: Sensipar

In chronic renal disease, a disturbance in calcium, phosphate, and vitamin D metabolism lead to a condition called secondary hyperparathyroidism , which is characterized by abnormally high levels of parathyroid hormone (PTH) levels in the blood. The high PTH levels lead to uremic bone disease. A recently approved drug, Cinacalcet HCL is effective in lowering the elevated PTH levels in chronic renal failure patients. It is taken by mouth.

Possible side effects include:

• Nausea
• Vomiting
• Transient low blood calcium level

Diuretics

Common names include:

• Furosemide (Lasix)
• Bumetanide (Bumex)

Diuretics help rid the body of excess fluid. These medications are sometimes referred to as “water pills.” Diuretics may be taken by mouth or, in some cases, by injection.

Possible side effects include:

• Dizziness
• Mouth dryness
• Weakness
• Frequent urination

Sevelamer

• Common name: Renagel

This agent, which is taken by mouth, binds phosphate to prevent increased blood phosphate levels that can lead to weakening of bones. The medication does not contain calcium, aluminum, or magnesium.

Possible side effects include:

• Nausea
• Diarrhea
• Upset stomach

Recombinant Human Erythropoietin (Epoetin Alfa)

Common names include:

• Epogen
• Procrit

This drug is injected and used to treat anemia associated with renal failure. It stimulates production of red blood cells.

Possible side effects include:

• Headache
• Increased blood pressure
• Joint aches
• Nausea

Sodium Bicarbonate

Typically taken orally, sodium bicarbonate may be ordered if you develop a condition called metabolic acidosis, which is an excess of acid in the blood due to alterations in metabolism from kidney failure.

If you need to use sodium bicarbonate, you should review your dietary sodium intake with your physician or dietician, since this medication will increase the sodium in your diet.

Calcium Carbonate or Calcium Acetate

Calcium supplements are given to bind phosphate in order to maintain phosphate levels within a range that will not increase bone loss. These drugs are taken orally.

Possible side effects include:

• Constipation
• Loss of appetite
• Slow heart rate

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

• Take them as directed—not more, not less, not at a different time.
• Do not stop taking them without consulting your healthcare provider.
• Don’t share them with anyone else.
• Know what effects and side effects to expect, and report them to your healthcare provider.
• If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
• Plan ahead for refills so you don’t run out.

When to Contact Your Healthcare Provider

Call your healthcare provider if you develop side effects from the medications or experience:

• Signs of infection, including fever and chills
• Nausea or vomiting
• Abdominal pain
• Dizziness or weakness