[Prevention and treatment of secondary hyperparathyroidism in non-dialyzed patients with stage 3-5 chronic kidney diease].
Deficiencies in vitamin D and vitamin D receptor (VDR) activation adversely affect cardiovascular health in the general population and in people at high risk of cardiovascular disease, as well as contributing to secondary hyperparathyroidism in patients with chronic kidney disease (CKD). Furthermore, epidemiological and observational data indicate that there is a close interrelationship between progressive renal dysfunction in CKD, cardiovascular disease, and mortality. The causes of death in patients even with only moderate kidney dysfunction are commonly associated with cardiovascular events. Modulation of vitamin D levels results in correlative regulatory effects on mineral homeostasis, hypertension, vascular disease, and calcification, as well as a number of other endpoints in cardiac and renal disease. The use of VDR activators to treat these and other parameters outside of cardiovascular and renal disease not only results in enhanced patient health but significantly lowers the risk of mortality in CKD and non-CKD patients with low systemic activity of vitamin D. The cardiovascular and renal systems continue to demonstrate their interrelated effects on each other, particularly when vitamin D and VDR signaling are considered.
Cozzolino
M
M
U.O. Nefrologia e Dialisi, Ospedale San Paolo, Milano - Italy. mariocozzolino@hotmail.com
Olivi
L
L
Voli
E
E
Ciceri
P
P
Brancaccio
D
D
D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002117:Calcitriol / Q000627:therapeutic use*; D002120:Calcium Channel Agonists / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D002908:Chronic Disease; D000069449:Cinacalcet; D018450:Disease Progression; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D009281:Naphthalenes / Q000627:therapeutic use; D018167:Receptors, Calcitriol / Q000187:drug effects*; D006435:Renal Dialysis / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D002120:Calcium Channel Agonists; D009281:Naphthalenes; D018167:Receptors, Calcitriol; D002117:Calcitriol; D000069449:Cinacalcet