TY - JOUR
T1 - Calcimimetics in the chronic kidney disease-mineral and bone disorder
AU - Bover, Jordi
AU - Aguilar, Armando
AU - Baas, Juan P.
AU - Reyes, Joselyne
AU - Lloret, Maria J.
AU - Farré, Neus
AU - Olaya, Mayte
AU - Canal, Cristina
AU - Marco, Helena
AU - Andrés, Enric
AU - Trinidad, Pedro
AU - Ballarín, José
PY - 2009/1/1
Y1 - 2009/1/1
N2 - 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.
AB - 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.
KW - Calcimimetics
KW - Cinacalcet
KW - CKD-MBD
KW - Secondary hyperparathyroidism
KW - Vascular calcification
U2 - 10.1177/039139880903200208
DO - 10.1177/039139880903200208
M3 - Review article
VL - 32
SP - 108
EP - 121
JO - International Journal of Artificial Organs
JF - International Journal of Artificial Organs
SN - 0391-3988
IS - 2
ER -