HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Calcimimetics in peritoneal dialysis patients.

Abstract
Though the prevalence of secondary hyperparathyroidism (SHP) and the related mineral metabolism (MM) changes have been reported at almost the same rate in peritoneal dialysis (PD) as in hemodialysis (HD) patients, PD patients have a higher prevalence of adynamic bone disease (ABD), suggesting that their bone is less sensitive for a given level of PTH. Furthermore, the phosphorus control seems to be better and vitamin D deficiency is more common in PD patients than in HD patients. So, the therapeutic approach to SHP and MM changes in PD patients might be different from the one applied to HD patients. Vitamin D metabolites and phosphate binders, though effective in controlling SHP of CKD patients, are not equally effective in controlling at the same extent calcium and/or phosphorus levels. Recently, a new drug (Cinacalcet) has been introduced in the clinical practice which significantly increased the chance of obtaining a simultaneous control of both PTH and MM parameters. However, only scanty data are present in the literature regarding the use of Cinacalcet in PD patients. The few studies produced in PD retraced the results obtained in hemodialysis patients, confirming that both in the short- and long-term Cinacalcet induced a more pronounced reduction of PTH in a larger percentage of patients as compared with standard therapy (ST), and this effect was associated with a decrease in both calcium and phosphorus concentrations, though the extent of the percentage decrease of phosphorus was lower than in HD patients. The safety/tolerability profile was again the same as in HD patients, with gastrointestinal symptoms representing the more frequently reported side effects. In our experience, given that a severe form of SHP is less frequent, the control of phosphate is usually better and vitamin D deficiency is more frequent in PD than in HD patients, making the former patients more prone to hypo- rather than hypercalcemia, the need for the use of the most recent and potent drugs for the control of SHP, including Cinacalcet, is usually lower in PD than in HD patients.
AuthorsPiergiorgio Messa, Claudia Castelnovo, Antonio Scalamogna
JournalContributions to nephrology (Contrib Nephrol) Vol. 178 Pg. 143-149 ( 2012) ISSN: 1662-2782 [Electronic] Switzerland
PMID22652729 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
CopyrightCopyright © 2012 S. Karger AG, Basel.
Chemical References
  • Calcimimetic Agents
  • Naphthalenes
  • Cinacalcet
Topics
  • Calcimimetic Agents (therapeutic use)
  • Cinacalcet
  • Humans
  • Hyperparathyroidism, Secondary (drug therapy)
  • Naphthalenes (therapeutic use)
  • Peritoneal Dialysis (adverse effects)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: