Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review

Bolasco, Piergiorgio (2009) Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review. Clinical cases in mineral and bone metabolism, 6 (3). pp. 210-219. ISSN 1971-3266

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Abstract

Secondary hyperparathyroidism (SHPT) is an early complication and a well-known factor negatively affecting cardiovascular mortality already in the late stages of chronic kidney disease (CKD). Negative effects can also be foreseen in early stages of CKD. Aim: Set against this background, I performed detailed clinical review of the specific literature from 1975 on the various types of trials used to treat SHPT in order to assess their effect on uremic patients affected by CKD stage 3 stage 4. Results: Out of the 1,820 papers reviewed, I identified 14 prospective controlled randomized trials involving in total 1,587 patients. Dietary approaches and the use of phosphorus chelating agents, either alone or in association, do not seem to be particularly promising for SHPT in uremic patients with CKD stage 3-4. Pending the publication of statistically wellstructured works on CKD stage 3-4, experience with calciummimetic agents in CKD stage 3-4 seems promising, even if there is a need to decrease the side effects most affecting medication compliance and as well safety calcium-mimetic agents seem to be more useful, especially in association with vitamin D derivatives. Further promising results seem to be provided by the latest generations of vitamin D derivatives such as paracalcitol which produces good SHPT control

Item Type:	Article
Uncontrolled Keywords:	Secondary hyperparathyroidism, SHPT, chronic kidney disease stages 3-4, chronic renal failure stages 3-4
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 611 Anatomia; Citologia; Istologia umana > 611.7 Sistema muscoloscheletrico, tegumento
Depositing User:	Danilo Dezzi
Date Deposited:	14 Jan 2014 14:32
Last Modified:	14 Jan 2014 14:39
URI:	http://eprints.bice.rm.cnr.it/id/eprint/5546

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