[Treatment of CKD-MBD targeting the parathyroid gland]

Secondary hyperparathyroidism is a major component of chronic kidney disease-mineral and bone disorder (CKD-MBD) and has a considerable impact on morbidity and mortality through the development of high-turnover bone disease and vascular calcification. Thus, management of secondary hyperparathyroidism is important for improving the outcomes of CKD patients. Because there is a fundamental difference in the pathogenesis of secondary hyperparathyroidism between predialysis and dialysis patients, different therapeutic approach should be considered for each condition. In this article, we summarize the treatment of CKD-MBD for managing secondary hyperparathyroidism, with a particular focus on the difference between predialysis and dialysis stages of CKD.