Is It Worth Correcting Hyperparathyroidism if Hyperphosphatemia and Hypocalcemia Worsen? A Cinacalcet Story

摘要

Mineral and bone disorders (MBD) are common and are associated with adverse outcomes in chronic kidney disease (CKD). The 2 fundamental questions are whether there are effective interventions to correct CKD-MBD and, if so, whether such interventions improve outcomes. Treatment modalities for CKD-MBD range from nutritional interventions to various pharmaceutical agents. The aims of therapy are to correct hyperparathyroidism and to control serum phosphorus and calcium levels. In this issue of the American Journal of Kidney Diseases, Chonchol and colleagues report the results of a phase 3 trial of cinacalcet for treatment of hyperparathyroidism in CKD patients. In this editorial, we review the implications of cinacalcet therapy on serum phosphorus and calcium across the range of CKD stages