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New therapies: calcimimetics, phosphate binders and vitamin D receptor activators.
Pediatr Nephrol. 2010 Apr; 25(4):609-16.PN

Abstract

At present, new compounds are available to treat secondary hyperparathyroidism, namely calcimimetics, novel phosphorus binders and also novel vitamin D receptor activators. Calcimimetics increase the sensitivity of the parathyroid gland to calcium through spatial configurational changes of the calcium-sensing receptor. In addition, experimental studies have demonstrated that calcimimetics also upregulate both the calcium-sensing receptor and the vitamin D receptor. They are efficacious in children, though the experience in paediatric chronic kidney disease is still limited. Sevelamer, lanthanum carbonate and magnesium iron hydroxycarbonate are novel phosphorus binders available on the market. Several studies have demonstrated their efficacy and safety up to 6 years, though costs are the main limitation for a wider use. Since almost all the experience available on the new phosphorus binders comes from its use in adults, studies on children are needed in order to confirm the efficacy and safety of these products. Other new salts and polymers are also being developed. New vitamin D receptor activators, such as paricalcitol, are as effective at suppressing parathyroid hormone (PTH) as the traditional vitamin D receptor activators used for the past two decades, but they have a better and safer profile, showing fewer calcaemic and phosphoraemic effects while preserving the desirable effects of the vitamin D receptor activators on the cardiovascular system, hypertension, inflammation and fibrosis. Their use in children with chronic kidney disease has revealed similar responses to those of adults. The novel compounds discussed in this review should facilitate and improve the management of mineral and bone disorders in children with chronic kidney disease.

Authors+Show Affiliations

Bone and Mineral Research Unit, Instituto Reina Sofia de Investigación, REDinREN ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Julián Clavería S/N, 33006 Asturias, Spain. cannata@hca.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20151157

Citation

Cannata-Andía, Jorge B., et al. "New Therapies: Calcimimetics, Phosphate Binders and Vitamin D Receptor Activators." Pediatric Nephrology (Berlin, Germany), vol. 25, no. 4, 2010, pp. 609-16.
Cannata-Andía JB, Rodriguez-García M, Román-García P, et al. New therapies: calcimimetics, phosphate binders and vitamin D receptor activators. Pediatr Nephrol. 2010;25(4):609-16.
Cannata-Andía, J. B., Rodriguez-García, M., Román-García, P., Tuñón-le Poultel, D., López-Hernández, F., & Rodríguez-Puyol, D. (2010). New therapies: calcimimetics, phosphate binders and vitamin D receptor activators. Pediatric Nephrology (Berlin, Germany), 25(4), 609-16. https://doi.org/10.1007/s00467-010-1462-9
Cannata-Andía JB, et al. New Therapies: Calcimimetics, Phosphate Binders and Vitamin D Receptor Activators. Pediatr Nephrol. 2010;25(4):609-16. PubMed PMID: 20151157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New therapies: calcimimetics, phosphate binders and vitamin D receptor activators. AU - Cannata-Andía,Jorge B, AU - Rodriguez-García,Minerva, AU - Román-García,Pablo, AU - Tuñón-le Poultel,Diego, AU - López-Hernández,Francisco, AU - Rodríguez-Puyol,Diego, Y1 - 2010/02/12/ PY - 2009/08/03/received PY - 2010/01/07/accepted PY - 2009/12/23/revised PY - 2010/2/13/entrez PY - 2010/2/13/pubmed PY - 2010/6/3/medline SP - 609 EP - 16 JF - Pediatric nephrology (Berlin, Germany) JO - Pediatr Nephrol VL - 25 IS - 4 N2 - At present, new compounds are available to treat secondary hyperparathyroidism, namely calcimimetics, novel phosphorus binders and also novel vitamin D receptor activators. Calcimimetics increase the sensitivity of the parathyroid gland to calcium through spatial configurational changes of the calcium-sensing receptor. In addition, experimental studies have demonstrated that calcimimetics also upregulate both the calcium-sensing receptor and the vitamin D receptor. They are efficacious in children, though the experience in paediatric chronic kidney disease is still limited. Sevelamer, lanthanum carbonate and magnesium iron hydroxycarbonate are novel phosphorus binders available on the market. Several studies have demonstrated their efficacy and safety up to 6 years, though costs are the main limitation for a wider use. Since almost all the experience available on the new phosphorus binders comes from its use in adults, studies on children are needed in order to confirm the efficacy and safety of these products. Other new salts and polymers are also being developed. New vitamin D receptor activators, such as paricalcitol, are as effective at suppressing parathyroid hormone (PTH) as the traditional vitamin D receptor activators used for the past two decades, but they have a better and safer profile, showing fewer calcaemic and phosphoraemic effects while preserving the desirable effects of the vitamin D receptor activators on the cardiovascular system, hypertension, inflammation and fibrosis. Their use in children with chronic kidney disease has revealed similar responses to those of adults. The novel compounds discussed in this review should facilitate and improve the management of mineral and bone disorders in children with chronic kidney disease. SN - 1432-198X UR - https://www.unboundmedicine.com/medline/citation/20151157/New_therapies:_calcimimetics_phosphate_binders_and_vitamin_D_receptor_activators_ L2 - https://dx.doi.org/10.1007/s00467-010-1462-9 DB - PRIME DP - Unbound Medicine ER -