| Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U". | |
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MedLine Citation:
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PMID: 19473626 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Cozzolino; V Brandenburg |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Clinical nephrology Volume: 71 ISSN: 0301-0430 ISO Abbreviation: Clin. Nephrol. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-28 Completed Date: 2009-07-23 Revised Date: 2013-05-30 |
Medline Journal Info:
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Nlm Unique ID: 0364441 Medline TA: Clin Nephrol Country: Germany |
Other Details:
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Languages: eng Pagination: 593-601 Citation Subset: IM |
Affiliation:
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Division of Nephrology, University of Milan, S Paolo Hospital, Milan, Italy. mariocozzolino@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Calcium
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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:
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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:
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Clin Nephrol. 2009 Jul;72(1):82 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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