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Etelcalcetide vs Cinacalcet Practical — ESENeph MCQ

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EasyHaemodialysisEtelcalcetide vs Cinacalcet PracticalESENeph

A 45-year-old woman with CKD G4 and secondary hyperparathyroidism asks about Etelcalcetide versus Cinacalcet. She is on haemodialysis. What is the key practical advantage of Etelcalcetide?

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Correct answer: A — It is given IV at the end of dialysis, ensuring adherence – useful for patients who cannot tolerate oral Cinacalcet (GI side effects) or who have poor medication adherence

Etelcalcetide is an IV calcimimetic given at the end of each haemodialysis session by dialysis staff. This eliminates adherence issues (Cinacalcet oral adherence is notoriously poor – often <50% at 1 year) and bypasses GI side effects (nausea, vomiting) that limit oral Cinacalcet tolerability. Both agents activate the calcium-sensing receptor on parathyroid cells to suppress PTH. Etelcalcetide tends to cause more hypocalcaemia than Cinacalcet, requiring close calcium monitoring.

Reference: Block et al 2017 – Etelcalcetide; KDIGO 2017 – CKD-MBD