| Summary: | <p>Abstract</p> <p>Introduction</p> <p>The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions, phosphate binders, active vitamin D analogs, and calcimimetics.</p> <p>Case presentation</p> <p>We report the case of a 36-year-old Hispanic dialysis patient, originally from Cuba and now residing in the USA, who developed severe bone pain and muscle twitching after starting low dose cinacalcet, despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet.</p> <p>Conclusion</p> <p>Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients.</p>
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