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Management of mineral and bone disorder in chronic kidney disease: quo vadis?

Kentaro Nakai1, Hirotaka Komaba, Masafumi Fukagawa

  • 1Division of Nephrology and Kidney Center, Kobe University School of Medicine, Kobe, Japan.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|September 22, 2009
PubMed

Insights

Calcimimetic cinacalcet effectively manages mineral and bone disorder in chronic kidney disease (CKD-MBD) by lowering parathyroid hormone. Further research is needed to optimize combination therapies with vitamin D analogs for improved patient outcomes.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Mineral and bone disorder in chronic kidney disease (CKD-MBD) significantly increases morbidity and mortality.
  • Secondary hyperparathyroidism is a common complication in dialysis patients.
  • Cinacalcet hydrochloride represents a significant advancement in CKD-MBD management.

Purpose of the Study:

  • To review the efficacy of cinacalcet in managing secondary hyperparathyroidism in dialysis patients.
  • To compare the effects of cinacalcet with vitamin D analogs on mineral metabolism.
  • To explore the potential of combination therapy with calcimimetics and vitamin D analogs.

Main Methods:

  • Review of numerous clinical studies on cinacalcet in dialysis patients.
  • Comparison of therapeutic effects on serum parathyroid hormone, calcium, and phosphorus levels.
  • Analysis of emerging research on combination therapies.

Main Results:

  • Cinacalcet effectively reduces serum parathyroid hormone levels in dialysis patients with secondary hyperparathyroidism.
  • Unlike vitamin D analogs, cinacalcet does not increase serum calcium and phosphorus levels.
  • Combination therapy with calcimimetics and low-dose vitamin D analogs is under investigation.

Conclusions:

  • Cinacalcet offers a valuable therapeutic option for CKD-MBD, particularly secondary hyperparathyroidism.
  • Optimal combination strategies and primary therapy choices between calcimimetics and vitamin D analogs require further investigation.
  • Future research should focus on improving patient-level outcomes through refined therapeutic approaches for CKD-MBD.

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