Calcimimetics versus vitamin D: what are their relative roles?

Abstract

A strict control of secondary hyperparathyroidism in patients with chronic kidney disease (CKD) is indicated to avoid serious complications linked to osteitis fibrosa and other parathyroid-hormone (PTH)-related bodily disturbances. However, such a control is often achieved only at the price of unacceptably high plasma calcium and phosphorus levels and the risk of soft tissue calcification, even when using the novel, so-called 'non-hypercalcemic' vitamin D analogs. The advent of a new class of drugs, the calcimimetics, should allow a more adequate control of the disturbed calcium-phosphorus metabolism in CKD patients. In my opinion, the calcimimetics will not replace currently used medications but will be a valuable supplement to presently available treatment options for this major complication in patients with renal failure.

• Authors: Tilman B Drüeke
• Journal: Blood purification (Blood Purif) Vol. 22 Issue 1 Pg. 38-43 ( 2004) ISSN: 0253-5068 [Print] Switzerland
• PMID: 14732810 (Publication Type: Comparative Study, Journal Article, Review)
• Copyright: Copyright 2004 S. Karger AG, Basel

Chemical References

• Ergocalciferols
• Hydroxycholecalciferols
• Naphthalenes
• Phosphates
• Receptors, Calcitriol
• Receptors, Calcium-Sensing
• Vitamin D
• 1 alpha-hydroxyergocalciferol
• paricalcitol
• Calcitriol
• maxacalcitol
• Cinacalcet
• alfacalcidol

Topics

• Calcitriol (adverse effects, analogs & derivatives, metabolism, pharmacology, therapeutic use)
• Cinacalcet
• Clinical Trials as Topic
• Drug Synergism
• Ergocalciferols (pharmacology, therapeutic use)
• Humans
• Hydroxycholecalciferols (adverse effects, therapeutic use)
• Hypercalcemia (chemically induced)
• Hyperparathyroidism, Secondary (etiology, prevention & control)
• Intestinal Absorption (drug effects)
• Kidney Failure, Chronic (blood, complications)
• Liver (drug effects, metabolism)
• Naphthalenes (pharmacokinetics, therapeutic use)
• Phosphates (blood)
• Receptors, Calcitriol (drug effects, metabolism)
• Receptors, Calcium-Sensing (agonists, physiology)
• Vitamin D (adverse effects, therapeutic use)
• Vitamin D Deficiency (drug therapy, etiology)