Role of cinacalcet in management of mineral bone disorder in chronic kidney disease (control of calcium, phosphorus and parathyroid hormone).
The management of hemodialysis patients with chronic kidney disease-mineral bone disorder includes treatment to control levels of calcium, phosphorus and parathyroid hormone, so as to prevent bone and soft-tissue complications. Recently, pleiotropic effects of active vitamin D have attracted much attention, and its effect on outcome has also gained recognition. However, administration of active vitamin D may cause hypercalcemia and hyperphosphatemia. Now, the use of a novel class of drugs, cinacalcet hydrochloride, has been proposed as a strategy to reduce parathyroid hormone secretion, while decreasing levels of serum calcium, phosphorus, and calcium x phosphorus products. Among subjects with secondary hyperparathyroidism undergoing hemodialysis, combined therapy with cinacalcet and vitamin D sterols improved achievement of the biochemical targets for chronic kidney disease-mineral bone disorder recommended by the guidelines.
Tahara
Hideki
H
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Asahi-cho, Abeno-ku, Osaka, Japan. hidekit@ka2.so-net.ne.jp
D002118:Calcium / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy*; D000069449:Cinacalcet; D004359:Drug Therapy, Combination; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000009:adverse effects
D009281:Naphthalenes; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium; D000069449:Cinacalcet