[Basic and clinical aspects of calcimimetics. The JSDT guideline and cinacalcet hydrochloride].
The guidelines for the management of secondary hyperparathyroidism in chronic dialysis patients by Japanese Society of Dialysis Therapy (The JSDT guideline) set the optimal levels of P, Ca and intact-PTH in dialysis patients as 3.5 - 6.0 mg/dL, 8.4 - 10.0 mg/dL, 60 - 180 pg/mL (or whole-PTH 35 - 106 pg/mL) , respectively. Active vitamin D therapy tends to cause the elevation of serum P/Ca levels along with the suppression of parathyroid function. Therefore, it was often difficult to keep P/Ca/PTH within the optimal levels simultaneously by medical therapies. Cinacalcet hydrochloride therapy has a potential to break through the situation since it decreases P/Ca levels while it suppresses parathyroid function.
Kazama
Junichiro James
JJ
Niigata University Medical and Dental Hospital, Division of Intensive Care Medicine, Japan.
D000069449:Cinacalcet; D017408:Guidelines as Topic; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D009281:Naphthalenes / Q000008:administration & dosage*; D044169:Receptors, Calcium-Sensing / Q000037:antagonists & inhibitors*
D009281:Naphthalenes; D044169:Receptors, Calcium-Sensing; D000069449:Cinacalcet