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01-03-2005 | Review

Treatment of secondary hyperparathyroidism of dialysis patients with calcimimetics as a valuable addition to established therapeutic means

Author: Tilman B. Drüeke

Published in: Pediatric Nephrology | Issue 3/2005

Abstract

Currently available options for the treatment of hyperparathyroidism secondary to chronic renal failure do not allow the achievement of target values for plasma calcium, phosphorus, and parathyroid hormone in the majority of patients with chronic kidney disease (CKD) stage 5. This is particularly true for CKD patients who have been referred to nephrologists late in the course of their disease and in whom prevention has not been possible. The advent of a new class of therapeutic agents, the calcimimetics, will allow an easier control of already established parathyroid overfunction, as has been demonstrated in several phase II studies and one phase III study with cinacalcet. Future studies will show whether an earlier start of treatment in patients with CKD stage 2, 3, and 4 allows the prevention of secondary hyperparathyroidism. Since all available experience has been gathered in adult patients it is also necessary to test the efficacy and safety of the calcimimetics in children with CKD.

Moe SM, Drueke TB (2003) Management of secondary hyperparathyroidism: the importance and the challenge of controlling parathyroid hormone levels without elevating calcium, phosphorus, and calcium-phosphorus product. Am J Nephrol 23:369–379

Eknoyan G, Levin A, Levin NW (2003) Bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42:1–201

Lorenzo V, Martin M, Rufino M, Jimenez A, Malo AM, Sanchez E, Hernandez D, Rodriguez M, Torres A (2001) Protein intake, control of serum phosphorus, and relatively low levels of parathyroid hormone in elderly hemodialysis patients. Am J Kidney Dis 37:1260–1266

Cunningham J, Makin H (1997) How important is vitamin D deficiency in uraemia? Nephrol Dial Transplant 12:16–18

Ghazali A, Fardellone P, Pruna A, Atik A, Achard JM, Oprisiu R, Brazier M, Remond A, Moriniere P, Garabedian M, Eastwood J, Fournier A (1999) Is low plasma 25-(OH)vitamin D a major risk factor for hyperparathyroidism and Looser’s zones independent of calcitriol? Kidney Int 55:2169–2177

Atik A, Ghazali A, Achard JM, Rida Z, Oprisiu R, Brazier M, Leflon P, Gueris J, Moriniere P, Sari Z, Fournier A (1997) La déplétion relative en vitamine D native: un facteur de risque potentiel chez l’hémodialysé algérien de lésions radiologiques d’hyperparathyroïdie et d’ostéomalacie indépendant de la calcitriolémie. Nephrologie 18:47–52

Teng M, Wolf M, Lowrie E, Ofsthun N, Lazarus JM, Thadhani R (2003) Survival of patients undergoing hemodialysis with paricalcitol or calcitriol therapy. N Engl J Med 349:446–456CrossRef

Drueke TB, McCarron DA (2003) Paricalcitol as compared with calcitriol in patients undergoing hemodialysis. N Engl J Med 349:496–499

Argilés A, Kerr PG, Canaud B, Flavier JL, Mion C (1993) Calcium kinetics and the long-term effects of lowering dialysate calcium concentration. Kidney Int 43:630–640

10.

Cunningham J, Beer J, Coldwell RD, Noonan K, Sawyer N, Makin HLJ (1992) Dialysate calcium reduction in CAPD patients treated with calcium carbonate and alfacalcidol. Nephrol Dial Transplant 7:63–68

11.

Chertow GM, Burke SK, Lazarus JM, Stenzel KH, Wombolt D, Goldberg D, Bonventre JV, Slatopolsky E (1997) Poly[allylamine hydrochloride] (RenaGel): a noncalcemic phosphate binder for the treatment of hyperphosphatemia in chronic renal failure. Am J Kidney Dis 29:66–71

12.

Slatopolsky EA, Burke SK, Dillon MA (1999) RenaGel (R), a nonabsorbed calcium- and aluminum-free phosphate binder, lowers serum phosphorus and parathyroid hormone. Kidney Int 55:299–307

13.

Chertow GM, Burke SK, Raggi P (2002) Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients. Kidney Int 62:245–252CrossRef

14.

Katsumata K, Kusano K, Hirata M, Tsunemi K, Nagano N, Burke SK, Fukushima N (2003) Sevelamer hydrochloride prevents ectopic calcification and renal osteodystrophy in chronic renal failure rats. Kidney Int 64:441–450

15.

Cozzolino M, Staniforth ME, Liapis H, Finch J, Burke SK, Dusso AS, Slatopolsky E (2003) Sevelamer hydrochloride attenuates kidney and cardiovascular calcifications in long-term experimental uremia. Kidney Int 64:1653–1661CrossRef

16.

D’Haese PC, Spasovski GB, Sikole A, Hutchison A, Freemont TJ, Sulkova S, Swanepoel C, Pejanovic S, Djukanovic L, Balducci A, Coen G, Sulowicz W, Ferreira A, Torres A, Curic S, Popovic M, Dimkovic N, De Broe ME (2003) A multicenter study on the effects of lanthanum carbonate (Fosrenol) and calcium carbonate on renal bone disease in dialysis patients. Kidney Int [Suppl] S73–S78

17.

Lefebvre A, de Vernejoul MC, Gueris J, Goldfarb B, Graulet AM, Morieux C (1989) Optimal correction of acidosis changes progression of dialysis osteodystrophy. Kidney Int 36:1112–1118

18.

Graham KA, Hoenich NA, Tarbit M, Ward MK, Goodship THJ (1997) Correction of acidosis in hemodialysis patients increases the sensitivity of the parathyroid glands to calcium. J Am Soc Nephrol 8:627–631

19.

Brown EM, Pollak M, Riccardi D, Hebert SC (1994) Cloning and characterization of an extracellular Ca2+-sensing receptor from parathyroid and kidney: new insights into the physiology and pathophysiology of calcium metabolism. Nephrol Dial Transplant 9:1703–1706

20.

Shoback DM, Bilezikian JP, Turner SA, McCary LC, Guo MD, Peacock M (2003) The calcimimetic cinacalcet normalizes serum calcium in subjects with primary hyperparathyroidism. J Clin Endocrinol Metab 88:5644–5649CrossRefPubMed

21.

Quarles LD, Sherrard DJ, Adler S, Rosansky SJ, McCary LC, Liu W, Turner SA, Bushinsky DA (2003) The calcimimetic AMG 073 as a potential treatment for secondary hyperparathyroidism of end-stage renal disease. J Am Soc Nephrol 14:575–583PubMed

22.

Lindberg JS, Moe SM, Goodman WG, Coburn JW, Sprague SM, Liu W, Blaisdell PW, Brenner RM, Turner SA, Martin KJ (2003) The calcimimetic AMG 073 reduces parathyroid hormone and calcium×phosphorus in secondary hyperparathyroidism. Kidney Int 63:248–254

23.

Block GA, Martin KJ, deFrancisco ALM, Turner SA, Avram MM, Suranyi MG, Hercz G, Cunningham J, Abu-Alfa AK, Messa P, Coyne DW, Locatelli F, Cohen RM, Evenepoel P, Moe SM, Fournier A, Braun J, McCary LC, Zani VJ, Olson KA, Drueke TB, Goodman WG (2004) The calcimimetic cincalcet (AMG 073) for the treatment of secondary hyperparathyroidism in hemodialysis patients. N Engl J Med 350:1516–1525CrossRefPubMed

24.

Antonsen JE, Sherrard DJ, Andress DL (1998) A calcimimetic agent acutely suppresses parathyroid hormone levels in patients with chronic renal failure. Kidney Int 53:223–227

25.

Goodman WG, Frazao JM, Goodkin DA, Turner SA, Liu W, Coburn JW (2000) A calcimimetic agent lowers plasma parathyroid hormone levels in patients with secondary hyperparathyroidism. Kidney Int 58:436–445

26.

Goodman WG, Hladik GA, Turner SA, Blaisdell PW, Goodkin DA, Liu W, Barri YM, Cohen RM, Coburn JW (2002) The calcimimetic agent AMG 073 lowers plasma parathyroid hormone levels in hemodialysis patients with secondary hyperparathyroidism. J Am Soc Nephrol 13:1017–1024PubMed

27.

Moe SM, Sprague SM, Cunningham J, Drueke TB, Adler S, Rosansky SJ, Albizem MB, Guo MD, Zani V, Goodman WG (2003) Long-term treatment of secondary hyperparathyroidism (HPT) with the calcimimetic cinacalcet HCl. J Am Soc Nephrol 14:463A

28.

Brown EM, MacLeod RJ (2001) Extracellular calcium sensing and extracellular calcium signaling. Physiol Rev 81:239–297

29.

Wada M, Ishii H, Furuya Y, Fox J, Nemeth EF, Nagano N (1998) NPS R-568 halts or reverses osteitis fibrosa in uremic rats. Kidney Int 53:448–453

30.

Wada M, Furuya Y, Sakiyama J, Kobayashi N, Miyata S, Ishii H, Nagano N (1997) The calcimimetic compound NPS R-568 suppresses parathyroid cell proliferation in rats with renal insufficiency. Control of parathyroid cell growth via a calcium receptor. J Clin Invest 100:2977–2983PubMed

31.

Martin D, Miller G, Colloton M, Shatzen E, Lacey D (2003) Cincacalcet HCl decreases parathyroid hyperplasia in a rodent model of chronic renal insufficiency (CRI). J Am Soc Nephrol 14:462A

32.

Ogata H, Ritz E, Odoni G, Amann K, Orth SR (2003) Beneficial effects of calcimimetics on progression of renal failure and cardiovascular risk factors. J Am Soc Nephrol 14:959–967PubMed

Title: Treatment of secondary hyperparathyroidism of dialysis patients with calcimimetics as a valuable addition to established therapeutic means
Author: Tilman B. Drüeke
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 3/2005
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-004-1745-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment of secondary hyperparathyroidism of dialysis patients with calcimimetics as a valuable addition to established therapeutic means

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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