| Theme |
Evidence-based strategies for secondary hyperparathyroidism |
| Title |
Medical management and mortality |
| Author |
Hideki Tahara |
Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine |
| Author |
Yoshiki Nishizawa |
Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine |
| [ Summary ] |
Disturbances of calcium-phosphate and vitamin D metabolism in chronic kidney disease (CKD) play a key role in the development of secondary hyperparathyroidism. This not only causes renal osteodystrophy (ROD), but also significantly contributes to the high cardiovascular mortality of such patients. Calcification of coronary plaques, cardiac valves, and myocardial tissue are common pathologic findings in uremic hearts. Moreover, hyperphosphatemia and an increased calcium-phosphate product have been directly linked to increased mortality in a large number of hemodialysis patients. Similarly, increased mortality was also recently observed in patients with high levels of parathyroid hormone (PTH). To control hyperphosphatemia and high PTH levels of patients with CKD, brand-new vitamin D analogues and phosphate binders have recently been marketed in Japan. |