New strategies for the treatment of secondary hyperparathyroidism.

Abstract

Classic pathogeneses of secondary hyperparathyroidism (2HPT), hyperphosphatemia, vitamin D deficiency, and hypocalcemia, have been treated by the administration of phosphorus binders and vitamin D derivatives. However, these therapies have not brought about a successful result. The main reason could be attributed to hypercalcemia resulting from the administration of calcium salts as a phosphorus binder and the calcemic action of vitamin D. To prevent hypercalcemia, non-calcium-containing phosphorus binders and vitamin D analogues, which suppress parathyroid hormone (PTH) secretion with minimum calcemic action, have been developed. Furthermore, calcimimetics that stimulate the calcium-sensing receptor of parathyroid cells and suppress PTH secretion are now under clinical trial. Direct injection therapy of vitamin D analogues or calcimimetics into the parathyroid gland also has been reported. These new strategies are expected to effectively and safely suppress 2HPT, which has been resistant to conventional medical treatments.

• Authors: Tadao Akizawa, Kazuhiro Shiizaki, Ikuji Hatamura, Motohiro Kamimura, Masahide Mizobuchi, Nobuhiko Narukawa, Shinji Sumikado, Toshibumi Sakaguchi, Shigeo Negi, Hiroaki Ogata, Eriko Kinugasa
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 41 Issue 3 Suppl 1 Pg. S100-3 (Mar 2003) ISSN: 1523-6838 [Electronic] United States
• PMID: 12612963 (Publication Type: Journal Article, Review)

Chemical References

• Epoxy Compounds
• Polyamines
• Polyethylenes
• Vitamin D
• Phosphorus
• Sevelamer

Topics

• Animals
• Epoxy Compounds (therapeutic use)
• Humans
• Hyperparathyroidism (drug therapy, etiology)
• Phosphorus (metabolism)
• Polyamines
• Polyethylenes (therapeutic use)
• Sevelamer
• Vitamin D (analogs & derivatives, therapeutic use)