Klin Farmakol Farm. 2010;24(4):214-219

Prevention and treatment of secondary hyperparathyroidism in chronic kidney disease

František Švára

Interní odd. Strahov, Všeobecná fakultní nemocnice Praha

The current approach to secondary hyperparathyroidism (SHPT) in chronic kidney disease is much broader than in the past. The disorder

is now considered to be a part of a multisystem disease which implies not only deviations in the laboratory markers of bone metabolism,

but also the formation of extraosseous (predominantly vascular) calcifications and abnormalities in bone volume, mineralization and

turnover. This comprehensive view of the issue was the reason why a new term has been introduced: Chronic Kidney Disease-Mineral

and Bone Disorder (CKD-MBD). Based on the results of large mortality studies, current treatment for this disorder is no longer aimed

only at suppressing hyperparathyroidism. The goal is achievement and long-term maintenance of optimal levels of bone metabolism

parameters for minerals, including calcium and phosphate levels. The ultimate goal is to reduce (or at least to delay) the development

of vascular calcifications and, thus, reduce cardiovascular morbidity and mortality.

Keywords: secondary hyperparathyroidism, vitamin D analogues, calcimimetics, phosphate binders

Published: December 31, 2010  Show citation