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NDT Advance Access originally published online on September 6, 2005
Nephrology Dialysis Transplantation 2006 21(1):23-28; doi:10.1093/ndt/gfi097
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Current treatment options in secondary renal hyperparathyroidism

Helmut Reichel

Nephrological Center, Villingen-Schwenningen, Germany

Correspondence and offprint requests to: Prof. Dr H. Reichel, Nephrological Center, Schramberger Str. 28, Villingen-Schwenningen 78054, Germany. Email: helmut.reichel@dialyse-schwenningen.de

Keywords: calcimimetics; calcium; calcium–phosphorus product; chronic kidney disease; parathyroid hormone; phosphorus

The first 150 words of the full text of this article appear below.



   Introduction
 
Our view of the clinical problems associated with secondary renal hyperparathyroidism (SHPT) in end-stage renal-disease (ESRD) patients has changed considerably in the last few years. While it formerly was considered primarily a skeletal disorder, recent data show strong associations between renal SHPT and both disturbed bone/mineral metabolism and the development of cardiovascular calcifications, leading to cardiovascular morbidity and patient mortality [1–4]. Therapy for SHPT in ESRD includes active vitamin D metabolites, oral phosphate binders, calcium supplementation and, if pharmacological treatment is unsuccessful, surgical parathyroidectomy (PTx) [5]. However, some therapies to reduce PTH levels can exacerbate mineral imbalances, resulting in undesirable effects, such as hypercalcaemia and further hyperphosphataemia. Recently, a calcimimetic compound, cinacalcet, has been approved for treatment of renal SHPT. Cinacalcet offers a novel therapeutic concept by suppressing PTH synthesis and secretion via manipulation of the activity of the parathyroid calcium-sensing receptor (CaR). Herein, some of . . . [Full Text of this Article]



   Treatment targets and objectives
 
Vitamin D and vitamin D analogues
Phosphate binders
Calcimimetics


   Conclusions
 

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 Nephrol Dial TransplantHome page
H. Reichel
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Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2989 - 2990.
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Home page
 Nephrol Dial TransplantHome page
K. Wesseling and I. B. Salusky
Current treatment options in secondary hyperparathyroidism
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