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.