| Theme |
New frontiers of calcimimetics |
| Title |
Clinical effects of calcimimetics in patients with non-dialysis-dependent CKD and kidney transplant recipients |
| Author |
Naohiko Fujii |
Medical and Research Center for Nephrology and Transplantation, Hyogo Prefectural Nishinomiya Hospital |
| [ Summary ] |
Calcimimetics work as allosteric activators of the calcium sensing receptors in the parathyroid glands to lower the set point of serum ionized calcium (Ca) levels in the human body. These agents directly suppress parathyroid hormone (PTH) secretion and lower serum Ca and phosphate (P) levels at the same time, through which they exhibit many clinically-beneficial effects for dialysis patients. However, little is known about their effects among patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and kidney transplant recipients (KTRs). It is noteworthy that calcimimetics blunt the phosphaturic effects of PTH at the proximal tubules only to retain phosphorus in the body and raise serum P levels in patients with NDD-CKD. On the other hand, calcimimetics are thought to be a good treatment option for persistent hyperparathyroidism that emerges after kidney transplantation, when parathyroidectomy is considered to not be an option. Their long-term effects need to be elucidated. |