Kidney and Metabolic Bone Diseases Vol.30 No.4(8)

Theme Progress in parathyroid research : Pathophysiology and treatment
Title Management of parathyroid hormone levels in patients with chronic kidney disease : how and why?
Publish Date 2017/10
Author Hirotaka Komaba Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine / The Institute of Medical Sciences, Tokai University
[ Summary ] Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD), particularly among patients receiving dialysis. This disorder has a considerable impact on mortality through the development of high-turnover bone disease and vascular calcification. The introduction of cinacalcet hydrochloride, a calcimimetic agent, has revolutionized the treatment of SHPT. Currently, newer calcimimetics have been developed, which are expected to further improve the management of parathyroid hormone levels. Recent clinical studies have also suggested that effective treatment of SHPT, either through medical or surgical management, is associated with improved survival, which therefore provides a rationale for prompt treatment of SHPT. In this review, we outline recent evidence regarding the medical and surgical options for treatment of SHPT and their clinical impact on patient-level outcomes.
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