White Papers

Individualizing Therapy in Mineral and Bone Disorders: Directly Observed Cinacalcet Therapy on Hemodialysis Thrice Weekly

A Medical Clinical Affairs White Paper | September 2020

Individualizing Therapy in Mineral and Bone Disorders: Directly Observed Cinacalcet Therapy on Hemodialysis Thrice Weekly

Authors: Graham Abra MD, Tiffany Shang Pharm D, Rory Pace MPH, RD, CSR, FAND, Randy Chen MD, and Brigitte Schiller MD FACP FASN


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The medical management of Mineral and Bone Disorders in people with End Stage Kidney Disease (ESKD) on dialysis is challenging for both patients and clinicians.

In the attached White Paper, we review the available data for directly observed administration of the oral drug cinacalcet three times per week on hemodialysis. Satellite Healthcare In-Center hemodialysis facilities will be moving to cinacalcet administered 3x/week on dialysis as the default calcimimetic option in January 2021 as calcimimetic drugs enter the Medicare Prospective Payment System bundle.

The collaborative evaluation between treating nephrologists and RDs of In-Center patients will begin in November of 2020 for transition from current calcimimetics to cinacalcet administered 3x/week on dialysis in January 2021. Treating nephrologists will be closely involved in this transition and Parsabiv® will continue to be available for appropriate patients.