Direct bone effects of calcimimetics in chronic kidney disease?

Calcimimetics are widely used in patients on dialysis to treat secondary hyperparathyroidism. Our current view is that bone effects are only indirect through parathyroid hormone suppression. However, because bone cells express the calcium-sensing receptor, direct calcium-sensing receptor–mediated effects are also possible. New experimental data demonstrate direct anabolic bone actions of calcimimetics, independent of parathyroid hormone suppression. Because these effects could be clinically useful, further studies are necessary to confirm the validity of this observation.