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[Mechanism of uremic osteodystrophy and prevention of hyperparathyroidism in the uremic patient]. / Meccanismi dell'osteodistrofia uremica e prevenzione dell'iperparatiroidismo del soggetto uremico.
Brancaccio, D; Cozzolino, M; Galassi, A; Bellasi, A; Carpani, P; Gallieni, M.
Afiliación
  • Brancaccio D; Divisione di Nefrologia e Dialisi, Ospedale San Paolo, Milano, Italy. diego.brancaccio@tiscalinet.it
G Ital Nefrol ; 20 Suppl 22: S12-6, 2003.
Article en It | MEDLINE | ID: mdl-12851915
The management of secondary hyperparathyroidism is of crucial importance in the treatment of end stage renal disease (ESRD) patients. In particular, hypercalcemia, hyperphosphatemia, and elevated calcium x phosphate (Ca x P) product should be taken into consideration during administration of vitamin D metabolites for the control of PTH secretion. During the last 10 years, many authors have been studying the efficacy of new non-calcemic vitamin D analogs on suppressing secondary hyperparathyroidism in ESRD patients. In this brief review, we analyzed three new vitamin D analogs: 22-oxacalcitriol (Maxacalcitriol), 19-nor-1a, 25(OH)2D2 (Paracalcitriol), and 1a (OH)2D2 (Doxacalciferol). In addition, calcimimetic agents may represent a new pharmacologic choice to the treatment of secondary hyperparathyroidism, binding parathyroid calcium sensing receptors (CaSR) and reducing PTH secretion. These compounds may represent an important tool for the treatment of both secondary hyperparathyroidism and soft tissue calcifications in ESRD patients. In conclusion, a combined use of non calcemic phosphate binders, new vitamin D analogs and calcimimetics should be seriously considered to further improve the already known therapy of secondary hyperparathyroidism in ESRD patients.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica / Hiperparatiroidismo Secundario / Fallo Renal Crónico Tipo de estudio: Etiology_studies Límite: Humans Idioma: It Revista: G Ital Nefrol Asunto de la revista: NEFROLOGIA Año: 2003 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica / Hiperparatiroidismo Secundario / Fallo Renal Crónico Tipo de estudio: Etiology_studies Límite: Humans Idioma: It Revista: G Ital Nefrol Asunto de la revista: NEFROLOGIA Año: 2003 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia