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Treatment of secondary hyperparathyroidism in CKD patients with cinacalcet and/or vitamin D derivatives.
Clin J Am Soc Nephrol. 2009 Jan; 4(1):234-41.CJ

Abstract

The discovery of the calcium-sensing receptor (CaR) 15 yr ago was rapidly followed by the development of drugs modulating its activity, the so-called calcimimetics (increasing the CaR signal) and calcilytics (decreasing the CaR signal). The indication for calcimimetics is treatment of primary and secondary hyperparathyroidism, whereas calcilytics have potential for treatment of osteoporosis. A large number of clinical studies has shown that cinacalcet, the only presently available calcimimetic, effectively reduces serum parathyroid hormone in dialysis patients with secondary hyperparathyroidism. In contrast to the effect of active vitamin D derivatives, it simultaneously decreases serum calcium and phosphorus. Experimental studies showed a concomitant decrease in parathyroid hyperplasia. In the treatment of secondary hyperparathyroidism of dialysis patients, important questions remain unresolved, for example, whether there are reasons to prefer calcimimetics to active vitamin D derivatives and whether combined administration offers advantages compared with calcimimetics or active vitamin D given in isolation. For lowering parathyroid hormone, available evidence from recent studies suggests that combination therapy should be preferred to single drug treatment because of less side-effects and greater efficacy in controlling parathyroid overfunction. Future randomized controlled trial must answer whether calcimimetics impact on cardiovascular events or survival and whether in this respect there are differences between vitamin D sterols and calcimimetics.

Authors+Show Affiliations

INSERM Unité 845 and Service de Néphrologie, Hôpital Necker, Tour Lavoisier, Paris Cedex 15, France. tilman.drueke@inserm.frNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19056615

Citation

Drüeke, Tilman B., and Eberhard Ritz. "Treatment of Secondary Hyperparathyroidism in CKD Patients With Cinacalcet And/or Vitamin D Derivatives." Clinical Journal of the American Society of Nephrology : CJASN, vol. 4, no. 1, 2009, pp. 234-41.
Drüeke TB, Ritz E. Treatment of secondary hyperparathyroidism in CKD patients with cinacalcet and/or vitamin D derivatives. Clin J Am Soc Nephrol. 2009;4(1):234-41.
Drüeke, T. B., & Ritz, E. (2009). Treatment of secondary hyperparathyroidism in CKD patients with cinacalcet and/or vitamin D derivatives. Clinical Journal of the American Society of Nephrology : CJASN, 4(1), 234-41. https://doi.org/10.2215/CJN.04520908
Drüeke TB, Ritz E. Treatment of Secondary Hyperparathyroidism in CKD Patients With Cinacalcet And/or Vitamin D Derivatives. Clin J Am Soc Nephrol. 2009;4(1):234-41. PubMed PMID: 19056615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of secondary hyperparathyroidism in CKD patients with cinacalcet and/or vitamin D derivatives. AU - Drüeke,Tilman B, AU - Ritz,Eberhard, Y1 - 2008/12/03/ PY - 2008/12/6/pubmed PY - 2009/4/11/medline PY - 2008/12/6/entrez SP - 234 EP - 41 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 4 IS - 1 N2 - The discovery of the calcium-sensing receptor (CaR) 15 yr ago was rapidly followed by the development of drugs modulating its activity, the so-called calcimimetics (increasing the CaR signal) and calcilytics (decreasing the CaR signal). The indication for calcimimetics is treatment of primary and secondary hyperparathyroidism, whereas calcilytics have potential for treatment of osteoporosis. A large number of clinical studies has shown that cinacalcet, the only presently available calcimimetic, effectively reduces serum parathyroid hormone in dialysis patients with secondary hyperparathyroidism. In contrast to the effect of active vitamin D derivatives, it simultaneously decreases serum calcium and phosphorus. Experimental studies showed a concomitant decrease in parathyroid hyperplasia. In the treatment of secondary hyperparathyroidism of dialysis patients, important questions remain unresolved, for example, whether there are reasons to prefer calcimimetics to active vitamin D derivatives and whether combined administration offers advantages compared with calcimimetics or active vitamin D given in isolation. For lowering parathyroid hormone, available evidence from recent studies suggests that combination therapy should be preferred to single drug treatment because of less side-effects and greater efficacy in controlling parathyroid overfunction. Future randomized controlled trial must answer whether calcimimetics impact on cardiovascular events or survival and whether in this respect there are differences between vitamin D sterols and calcimimetics. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/19056615/Treatment_of_secondary_hyperparathyroidism_in_CKD_patients_with_cinacalcet_and/or_vitamin_D_derivatives_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=19056615 DB - PRIME DP - Unbound Medicine ER -