Secondary hyperparathyroidism - a common comorbid condition in patients with chronic renal insufficiency - is considered a consequence of critical determinants such as hypocalcemia, phosphate retention and reduced levels of calcitriol production. In this complex mechanism, the skeletal apparatus and the nonskeletal targets such as vascular and heart valves are often involved, thus explaining the increased risk of cardiovascular morbidity and mortality of uremic patients. In this review we will focus on the major role played by Calcitriol deficiency as a trigger of secondary hyperparathyroidism and the crucial need for obiquitous vitamin D receptor activation in order to have an optimal PTH control and to obtain a modulation between inhibitors and inducers of soft tissue calcification. This review will also elucidate the possible role of paricalcitol - a new vitamin D analog - in conditioning morbidity and mortality of patients on renal replacement therapy (RRT).

Management of secondary hyperparathyroidism in uremic patients : the role of the new vitamin D analogs / D. Brancaccio, M. Cozzolino, A. Galassi, G. Chiarelli, A. Butti, A. Bellasi, L. Rocca Rey, A. Volpi, A. Anelli, U. Zoni, M. Fusaro, C. Brambilla, E. Missaglia, C. Crovetto, M. Russo, C. Longhini, R. Provenzano, F. Incalcaterra, G. Cerasola, M. Li Vecchi, M. Gallieni. - In: JN. JOURNAL OF NEPHROLOGY. - ISSN 1121-8428. - 20:1(2007 Jan), pp. 3-9.

Management of secondary hyperparathyroidism in uremic patients : the role of the new vitamin D analogs

D. Brancaccio;M. Cozzolino;G. Chiarelli;A. Bellasi;L. Rocca Rey;M. Gallieni
2007-01

Abstract

Secondary hyperparathyroidism - a common comorbid condition in patients with chronic renal insufficiency - is considered a consequence of critical determinants such as hypocalcemia, phosphate retention and reduced levels of calcitriol production. In this complex mechanism, the skeletal apparatus and the nonskeletal targets such as vascular and heart valves are often involved, thus explaining the increased risk of cardiovascular morbidity and mortality of uremic patients. In this review we will focus on the major role played by Calcitriol deficiency as a trigger of secondary hyperparathyroidism and the crucial need for obiquitous vitamin D receptor activation in order to have an optimal PTH control and to obtain a modulation between inhibitors and inducers of soft tissue calcification. This review will also elucidate the possible role of paricalcitol - a new vitamin D analog - in conditioning morbidity and mortality of patients on renal replacement therapy (RRT).
Bone Density Conservation Agents; Calcitriol; Ergocalciferols; Humans; Hyperparathyroidism, Secondary; Hypocalcemia; Phosphates; Receptors, Calcitriol; Renal Insufficiency, Chronic; Uremia; Vitamin D; Vitamin D Deficiency; Bone Density Conservation Agents
Settore MED/14 - Nefrologia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/43424
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