Persistent uncertainties in optimal treatment approaches of secondary hyperparathyroidism and hyperphosphatemia in patients with chronic kidney disease.

Autor: Via Reque Cortes DDP; Laboratório de Fisiopatologia Renal, Faculdade de Medicina da USP, Nephrology Division, LIM 16, São Paulo, Brazil., Drueke TB; Inserm Unit 1018, CESP, Hôpital Paul Brousse, Paris-Sud University (UPS) and Versailles Saint-Quentin-en-Yvelines University (Paris-Ile-de-France-Ouest University, UVSQ), Team 5, Villejuif, France., Moysés RMA; Laboratório de Fisiopatologia Renal, Faculdade de Medicina da USP, Nephrology Division, LIM 16, São Paulo, Brazil. rosa.moyses@uol.com.br.
Jazyk: angličtina
Zdroj: Current osteoporosis reports [Curr Osteoporos Rep] 2024 Oct; Vol. 22 (5), pp. 441-457. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1007/s11914-024-00881-3
Abstrakt: Purpose of Review: This review is a critical analysis of treatment results obtained in clinical trials conducted in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT), hyperphosphatemia, or both.
Recent Findings: Patients with CKD have a high mortality rate. The disorder of mineral and bone metabolism (CKD-MBD), which is commonly present in these patients, is associated with adverse outcomes, including cardiovascular events and mortality. Clinical trials aimed at improving these outcomes by modifying CKD-MBD associated factors have most often resulted in disappointing results. The complexity of CKD-MBD, where many players are closely interconnected, might explain these negative findings. We first present an historical perspective of current knowledge in the field of CKD-MBD and then examine potential flaws of past and ongoing clinical trials targeting SHPT and hyperphosphatemia respectively in patients with CKD.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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