Renal osteodystrophy: role of calcimimetics.
In patients with secondary hyperparathyroidism (HPT), increased parathyroid hormone (PTH) secretion is triggered by low plasma calcitriol levels, hypocalcemia, and hyperphosphatemia. Vitamin D analogues have been used successfully to reduce PTH levels, but increases in serum calcium, phosphorus, and calcium x phosphorus ion product levels may occur. Second-generation calcimimetics have been shown to suppress PTH levels and also reduce calcium x phosphorus ion product. Potential indications are patients with secondary HPT, particularly those who respond to calcitriol therapy with an increase in calcium x phosphorus ion product. Coadministration of active vitamin D compounds may be necessary to overcome intestinal malabsorption of calcium and maintain normocalcemia in patients on long-term treatment with calcimimetics.
Hörl
Walter H
WH
Department of Medicine III, Division of Nephrology and Dialysis, University of Vienna, Austria. walter.hoerl@nephro.imed3.akh-wien.ac.at
D002118:Calcium / Q000819:agonists* / Q000097:blood / Q000627:therapeutic use*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D010281:Parathyroid Hormone / Q000037:antagonists & inhibitors / Q000097:blood
D010281:Parathyroid Hormone; D002118:Calcium