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Therapeutic strategies for secondary hyperparathyroidism in dialysis patients.
Ther Apher Dial. 2006 Aug; 10(4):355-63.TA

Abstract

Secondary hyperparathyroidism (SHPT) leads not only to bone disorders, but also to cardiovascular complications in long-term dialysis patients. Conventional treatment with calcium (Ca) supplement, phosphate (P) binders and active vitamin D analogs lead in part to amelioration of SHPT, but are simultaneously associated with unacceptable side-effects, including hypercalcemia, hyperphosphatemia, and increased Ca x P products, which are the risk factors for cardiovascular disease in dialysis patients. Conventional treatment has been unable to facilitate the attainment of optimal management of SHPT proposed in the K/DOQI guidelines. Cinacalcet HCl (cinacalcet), a novel calcimimetic compound, restores the sensitivity of the Ca-sensing receptor in parathyroid cells, and decreases serum parathyroid hormone (PTH) without introducing hypercalcemia or hyperphosphatemia. Cinacalcet treatment enables a significant number of patients to achieve the K/DOQI guideline. Based on experimental data, calcimimetics could ameliorate cardiovascular calcification and remodeling in uremic rats with SHPT. Clinical trials have shown that cinacalcet significantly reduced the risks of parathyroidectomy, fracture and cardiovascular hospitalization among long-term dialysis patients with SHPT. Parathyroid intervention therapy (parathyroidectomy and percutaneous direct injection) is also a useful alternative. In the present article, we review novel therapeutic strategies for SHPT.

Authors+Show Affiliations

Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan. ogatah@med.show-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16911189

Citation

Ogata, Hiroaki, et al. "Therapeutic Strategies for Secondary Hyperparathyroidism in Dialysis Patients." Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, vol. 10, no. 4, 2006, pp. 355-63.
Ogata H, Koiwa F, Ito H, et al. Therapeutic strategies for secondary hyperparathyroidism in dialysis patients. Ther Apher Dial. 2006;10(4):355-63.
Ogata, H., Koiwa, F., Ito, H., & Kinugasa, E. (2006). Therapeutic strategies for secondary hyperparathyroidism in dialysis patients. Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 10(4), 355-63.
Ogata H, et al. Therapeutic Strategies for Secondary Hyperparathyroidism in Dialysis Patients. Ther Apher Dial. 2006;10(4):355-63. PubMed PMID: 16911189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic strategies for secondary hyperparathyroidism in dialysis patients. AU - Ogata,Hiroaki, AU - Koiwa,Fumihiko, AU - Ito,Hidetoshi, AU - Kinugasa,Eriko, PY - 2006/8/17/pubmed PY - 2007/1/26/medline PY - 2006/8/17/entrez SP - 355 EP - 63 JF - Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy JO - Ther Apher Dial VL - 10 IS - 4 N2 - Secondary hyperparathyroidism (SHPT) leads not only to bone disorders, but also to cardiovascular complications in long-term dialysis patients. Conventional treatment with calcium (Ca) supplement, phosphate (P) binders and active vitamin D analogs lead in part to amelioration of SHPT, but are simultaneously associated with unacceptable side-effects, including hypercalcemia, hyperphosphatemia, and increased Ca x P products, which are the risk factors for cardiovascular disease in dialysis patients. Conventional treatment has been unable to facilitate the attainment of optimal management of SHPT proposed in the K/DOQI guidelines. Cinacalcet HCl (cinacalcet), a novel calcimimetic compound, restores the sensitivity of the Ca-sensing receptor in parathyroid cells, and decreases serum parathyroid hormone (PTH) without introducing hypercalcemia or hyperphosphatemia. Cinacalcet treatment enables a significant number of patients to achieve the K/DOQI guideline. Based on experimental data, calcimimetics could ameliorate cardiovascular calcification and remodeling in uremic rats with SHPT. Clinical trials have shown that cinacalcet significantly reduced the risks of parathyroidectomy, fracture and cardiovascular hospitalization among long-term dialysis patients with SHPT. Parathyroid intervention therapy (parathyroidectomy and percutaneous direct injection) is also a useful alternative. In the present article, we review novel therapeutic strategies for SHPT. SN - 1744-9979 UR - https://www.unboundmedicine.com/medline/citation/16911189/Therapeutic_strategies_for_secondary_hyperparathyroidism_in_dialysis_patients_ L2 - https://doi.org/10.1111/j.1744-9987.2006.00389.x DB - PRIME DP - Unbound Medicine ER -