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Nephrol Dial Transplant (2002) 17: 204-207
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Calcimimetic agents and secondary hyperparathyroidism: treatment and prevention

William G. Goodman

Division of Nephrology, Department of Medicine, UCLA School of Medicine, Los Angeles, CA, USA

Introduction

Calcimimetic agents are small organic molecules that act as allosteric activators of the calcium sensing receptor (CaSR) in the parathyroid glands and other tissues. They lower the threshold for CaSR activation by extracellular calcium ions and diminish parathyroid hormone (PTH) release from parathyroid cells. By targeting the molecular mechanism that modulates PTH secretion on a minute-to-minute basis, calcimimetic compounds offer a novel approach to managing excess PTH secretion in several clinical disorders [1].

Despite abundant in vitro and in vivo experimental work, experience with calcimimetic agents in humans is rather limited. Preliminary reports describe their use in small numbers of patients with primary hyperparathyroidism and in somewhat larger numbers of patients with secondary hyperparathyroidism due to end-stage renal disease [2–4]. Although the duration of treatment in published studies has been confined to 1 or 2 weeks, calcimimetic compounds consistently and reproducibly lower plasma PTH . . . [Full Text of this Article]

Mechanism of action

Lessons from early clinical trials with calcimimetic agents in secondary hyperparathyroidism

Effect on plasma PTH levels
Effect on blood ionized and serum calcium concentrations
Effect on serum phosphorus levels
Parathyroid gland hyperplasia

Summary

Acknowledgments

Notes

References


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