Document Detail


Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U".
MedLine Citation:
PMID:  19473626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Modern strategies to prevent secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients give great relevance to vitamin D replacement therapy. However, a sound approach to treatment requires taking into account many factors, including stage of CKD, underlying renal disorder, levels of circulating PTH, bone status, vitamin D deposits, and serum calcium (Ca) and phosphate (P) levels. The aim of vitamin D replacement therapy should be to prevent SHPT from the early stages of CKD, because once parathyroid hyperplasia and osteodystrophy develop, they cannot be completely reverted. The therapeutic strategies for SHPT are now changing. The availability of VDRAs allows inhibition of parathyroid glands with less effect on calcium and phosphate levels, and perhaps reduces the mortality of dialysis patients. Actual objectives for treating CKD patients with new generation VDRAs are to retain or amplify the effects of calcitriol on PTH suppression, with no effects on serum Ca and P levels. Paricalcitol is such a new VDRA with minimal impact on serum Ca and P levels. Since cardiovascular disease is the leading cause of morbidity and mortality in dialysis patients, these data suggest that the beneficial effect associated with paricalcitol injection on patient survival is at least partially related to its effect on the cardiovascular system.
Authors:
M Cozzolino; V Brandenburg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Clinical nephrology     Volume:  71     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-28     Completed Date:  2009-07-23     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  593-601     Citation Subset:  IM    
Affiliation:
Division of Nephrology, University of Milan, S Paolo Hospital, Milan, Italy. mariocozzolino@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Calcium / metabolism
Clinical Trials as Topic
Comorbidity
Ergocalciferols / therapeutic use*
Humans
Hyperparathyroidism, Secondary / epidemiology,  physiopathology,  prevention & control*
Kidney Failure, Chronic / drug therapy*,  epidemiology,  physiopathology
Naphthalenes / therapeutic use
Parathyroid Hormone / metabolism
Phosphorus / metabolism
Receptors, Calcitriol / agonists*
Treatment Outcome
Vitamins / therapeutic use*
Chemical
Reg. No./Substance:
0/Ergocalciferols; 0/Naphthalenes; 0/Parathyroid Hormone; 0/Receptors, Calcitriol; 0/Vitamins; 131918-61-1/paricalcitol; 7440-70-2/Calcium; 7723-14-0/Phosphorus; UAZ6V7728S/cinacalcet
Comments/Corrections
Erratum In:
Clin Nephrol. 2009 Jul;72(1):82

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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