| [ Summary ] |
The standard management of hemodialysis patients with CKD-MBD includes treatment to control levels of calcium, phosphorus and PTH, so as to prevent bone and soft-tissue complications. Recently, the use of a novel class of drugs, cinacalcet hydrochloride, has been proposed as a strategy to reduce PTH secretion, while decreasing levels of serum calcium, phosphorus and calcium x phosphorus products. Cinacalcet hydrochloride acts as an allosteric modulator of calcium-sensing receptor. The receptor is ubiquitously expressed in various cells. The question arose as to whether administration of this drug has effects beyond lowering PTH. To address this issue, some reports using animal models have illustrated cinacalcet is pleiotropic actions, including prevention of extraosseous calcifications. Furthermore, results of randomized controlled trials (RCTs) testing the efficacy and safety of cinacalcet are becoming available. However, several aspects of cinacalcet therapy in management of CKD-MBD require further evaluation. |