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Advances in pharmacotherapy for secondary hyperparathyroidism
Mariano Rodríguez1, María E Rodríguez-Ortiz
1Reina Sofía University Hospital/University of Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain Nephrology Service . REDinREN, Madrid , Spain +34 957 213 790 ; +34 957 010 452 ; marianorodriguezportillo@gmail.com.
Expert Opinion on Pharmacotherapy
|July 11, 2015
Summary
Secondary hyperparathyroidism, common in chronic kidney disease, requires management of phosphorus and calcium levels. Treatment options include dietary changes, binders, vitamin D sterols, calcimimetics, and parathyroid injections.
Area of Science:
- Nephrology
- Endocrinology
Background:
- Secondary hyperparathyroidism is a common complication in patients with chronic kidney disease (CKD).
- Effective management is crucial to prevent disease progression and associated complications.
Purpose of the Study:
- To review the therapeutic options for managing secondary hyperparathyroidism in CKD.
- To discuss strategies for preventing and slowing the progression of hyperparathyroidism.
Main Methods:
- Literature search of PubMed using terms 'secondary hyperparathyroidism' and specific drug names.
- Review of therapeutic strategies including dietary phosphorus control, phosphorus binders, dialysis adjustments, vitamin D sterols, calcimimetics, and percutaneous parathyroid injections.
Main Results:
- Dietary phosphorus control, binders, and increased dialysis frequency can reduce phosphatemia.
- Vitamin D sterols and calcimimetics lower parathyroid hormone (PTH) levels.
- Percutaneous injections offer an alternative for refractory cases.
Conclusions:
- PTH elevation begins early in renal disease.
- Pre-dialysis goals include preventing hyperphosphatemia and maintaining normal calcium levels.
- Dialysis management focuses on phosphorus control, with treatment decisions for calcimimetics and vitamin D based on calcium and phosphorus levels.
Keywords:
calcimimeticchronic kidney diseasedialysisdietary phosphorus restrictionparathyroid injectionphosphorus bindersecondary hyperparathyroidismvitamin DMore Related Videos
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