Nephrol Dial Transplant (2002) 17: 20-22
© 2002 European Renal Association-European Dialysis and Transplant Association
Treatment of secondary hyperparathyroidism with vitamin D derivatives and calcimimetics before and after start of dialysis
Inserm Unit 507 et Service de Néphrologie, Hôpital Necker, Paris, France
Abstract
Chronic renal failure is almost always associated with secondary uraemic hyperparathyroidism. Action should be taken as early as possible to avoid it or reduce its severity in patients with chronic kidney disease (CKD). Over the last decade, the most effective way of achieving this has been defined as therapy with active vitamin D derivatives. However, the so-called ‘non-hypercalcaemic’ vitamin D derivatives, which are said to be superior, have not met our expectations so far. In contrast, calcimimetic agents, the new class of compounds that act specifically on the calcium-sensing receptor, are very promising for the treatment and prevention of hyperparathyroidism. CKD is associated with disturbances in calcium, phosphate, and vitamin D metabolism that occur early in the course of renal disease. In most patients, these disturbances lead to secondary hyperparathyroidism and osteitis fibrosa or associated, more complex, skeletal lesions. Here, we focus on recent advances in the prevention and treatment of secondary hyperparathyroidism by vitamin D derivatives and by calcimimetic agents.
Keywords: anaemia; calcimimetics; chronic kidney disease; secondary hyperparathyroidism; vitamin D derivatives
Notes
Correspondence and offprint requests to: Dr Tilman B. Drüeke, Inserm Unit 507, Hôpital Necker, 161 rue de Sevres, F-75743 Paris Cedex 15, France. Email: drueke{at}necker.fr