[Calcimimetic agents in the treatment of hyperparathyroidism secondary to chronic renal failure]

The recent discovery and cloning of the extra cellular calcium sensing receptor (CaSR) has allowed a better understanding of the regulation of normal calcium metabolism and of rare disturbances in mineral metabolism. In the parathyroid glands the CaSR is responsible for modulating parathyroid hormone release as a function of the extra cellular calcium level. This discovery has allowed the development of drugs that mimics or potentiates the actions of extra cellular calcium on the CaSR, called calcimimetics that decrease parathyroid hormone secretion without increasing serum calcium. The new calcimimetics are small organic molecules that act as allosteric activators of the CaSR and they are in their initial face of clinical development. Although the experience with these drugs is limited, they have shown to effectively lower parathyroid hormone levels in patients with hyperparathyroidism secondary to end-stage renal failure without inducing important side-effects. Thus calcimimetic compounds have considerable potential as new drugs for the treatment of secondary hyperparathyroidism and uremic bone disease.