title: Vasculotropic effects of calcimimetics.
abstract: OBJECTIVE
  At all stages of chronic kidney disease (CKD) cardiovascular death is the most prominent cause of mortality. Current treatment options are still not completely satisfactory in this group of high cardiovascular risk patients. Experimental data and clinical observations suggest a role of secondary hyperparathyroidism, hyperphosphatemia, and hypercalcemia in the genesis of cardiovascular complications of CKD. The ubiquitous expression of the calcium-sensing receptor, which is targeted by calcimimetics and the pleiotropic effects of calcimimetics, make this class of drugs potential candidates for cardiovascular intervention.
  
  
  RESULTS
  Recent experimental studies suggest that calcimimetics interfere with the development of vascular abnormalities in CKD and to some extent even reverse them. The effects of calcimimetics on the vasculature are, at least partially, independent of their effects on calcemia, phosphatemia, and parathyroid hormone concentration. The beneficial effects of calcimimetics on vascular calcification, arteriolar thickening, atherogenesis, and myocardial capillarization are well documented. In addition they have hypotensive and renoprotective actions.
  
  
  CONCLUSIONS
  Experimental models suggest beneficial effects of calcimimetics on cardiovascular disease. Although prospective clinical data are still lacking, retrospective data suggest cardiovascular benefit of calcimimetics even in humans. Clinical trials with calcimimetics evaluating hard cardiovascular end-points would be desirable.
authors.affiliation: Department of Internal Medicine, University of Heidelberg, Heidelberg, Germany. nad_ko@gmx.de
authors.forename: Nadezda
authors.initials: N
authors.lastname: Koleganova
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Piecha
authors.forename: Eberhard
authors.initials: E
authors.lastname: Ritz
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002114:Calcinosis / Q000188:drug therapy / Q000517:prevention & control; D002118:Calcium / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D010281:Parathyroid Hormone / Q000378:metabolism; D044169:Receptors, Calcium-Sensing / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000378:metabolism; D012307:Risk Factors
chemical_list: D010281:Parathyroid Hormone; D044169:Receptors, Calcium-Sensing; D002118:Calcium