Calcimimetics in the chronic kidney disease-mineral and bone disorder

Jordi Bover, Armando Aguilar, Juan P. Baas, Joselyne Reyes, Maria J. Lloret, Neus Farré, Mayte Olaya, Cristina Canal, Helena Marco, Enric Andrés, Pedro Trinidad, José Ballarín

    Research output: Contribution to journalReview articleResearchpeer-review

    11 Citations (Scopus)

    Abstract

    Mineral and bone disorders (MBD) are both an early and very common complication of chronic kidney disease (CKD). It is now accepted that they represent a significant risk factor, explaining the high cardiovascular morbidity and mortality in CKD patients. During the last decade, we have been witnessing many advances in the nomenclature, classification, pathophysiology, diagnosis, and treatment of CKD and some of its complications, such as CKD-MBD. The identification of the calcium-sensing receptor (CaSR) involvement in the pathogenesis of primary and secondary hyperparathyroidism (SHPT) and the availability of a new class of drugs called calcimimetics are two outstanding examples. Cinacalcet, the only available calcimimetic, has been shown to be a very effective therapeutic tool in CKD-MBD. Many clinical trials with cinacalcet in hemodialysis patients with SHPT have shown a reduction in parathyroid hormone, calcium (Ca), phosphate (P) and Ca x P product levels, allowing far greater success in reaching therapeutic goals as recommended by international guidelines. Additionally, some studies have shown that the use of cinacalcet may improve other aspects of CKD-MBD, reducing the risk of vascular calcification and parathyroidectomy, among others. Prospective studies on dialysis patients, with hard endpoint data, are currently underway. This review summarizes the most significant aspects of calcimimimetics based on both experimental and clinical results, underlining their possibilities not only for the treatment of isolated SHPT but also for other CKD-MBD related conditions. © Wichtig Editore, 2009.
    Original languageEnglish
    Pages (from-to)108-121
    JournalInternational Journal of Artificial Organs
    Volume32
    Issue number2
    DOIs
    Publication statusPublished - 1 Jan 2009

    Keywords

    • Calcimimetics
    • Cinacalcet
    • CKD-MBD
    • Secondary hyperparathyroidism
    • Vascular calcification

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