Secondary hyperparathyroidism: Review of the disease and its treatment
Most patients with chronic kidney disease (CKD) stage 5 develop secondary hyperparathyroidism (SHPT). SHPT is an adaptive response to CKD and its associated disruptions in the homeostatic control of serum phosphorus, calcium, and vitamin D. The poor control of mineral and parathyroid hormone (PTH) l...
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| Veröffentlicht in: | Clinical therapeutics 2004-12, Vol.26 (12), p.1976-1993 |
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| container_title | Clinical therapeutics |
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| creator | de Francisco, Angel L.M. |
| description | Most patients with chronic kidney disease (CKD) stage 5 develop secondary hyperparathyroidism (SHPT). SHPT is an adaptive response to CKD and its associated disruptions in the homeostatic control of serum phosphorus, calcium, and vitamin D. The poor control of mineral and parathyroid hormone (PTH) levels characteristic of SHPT is associated with serious clinical consequences.
This review discusses the pathophysiology and consequences of SHPT, as well as the efficacy and limitations of current treatment modalities.
Literature searches were conducted using the MEDLINE, EMBASE, and BIOSIS databases. Additional information was obtained from Internet web sites, textbooks, and nephrology congress abstracts.
Patients with uncontrolled SHPT are at higher risk for cardiovascular morbidity and mortality, hospitalization, bone disease, vascular and soft-tissue calcification, and vascular access failure than patients whose mineral and PTH levels are well managed. New National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) targets for calcium, phosphorus, calcium-phosphorus product, and PTH control have recently been published with the aim of improving the management of mineral metabolism in CKD patients. Data from observational studies suggest that the majority of patients currently have PTH and mineral levels outside these target ranges.
Given the inadequacies of current therapies, novel agents are being developed that may help improve the management of SHPT. |
| doi_str_mv | 10.1016/j.clinthera.2004.12.011 |
| format | Article |
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This review discusses the pathophysiology and consequences of SHPT, as well as the efficacy and limitations of current treatment modalities.
Literature searches were conducted using the MEDLINE, EMBASE, and BIOSIS databases. Additional information was obtained from Internet web sites, textbooks, and nephrology congress abstracts.
Patients with uncontrolled SHPT are at higher risk for cardiovascular morbidity and mortality, hospitalization, bone disease, vascular and soft-tissue calcification, and vascular access failure than patients whose mineral and PTH levels are well managed. New National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) targets for calcium, phosphorus, calcium-phosphorus product, and PTH control have recently been published with the aim of improving the management of mineral metabolism in CKD patients. Data from observational studies suggest that the majority of patients currently have PTH and mineral levels outside these target ranges.
Given the inadequacies of current therapies, novel agents are being developed that may help improve the management of SHPT.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/j.clinthera.2004.12.011</identifier><identifier>PMID: 15823762</identifier><language>eng</language><publisher>Belle Mead, NJ: EM Inc USA</publisher><subject>Aluminum ; Biological and medical sciences ; Bone diseases ; Calcification ; calcium ; Calcium - blood ; calcium-phosphorus product ; chronic kidney disease ; Cinacalcet Hydrochloride ; Fractures ; Glomerular Filtration Rate - physiology ; Hemodialysis ; Humans ; Hyperparathyroidism, Secondary - etiology ; Hyperparathyroidism, Secondary - physiopathology ; Hyperparathyroidism, Secondary - therapy ; Hyperplasia ; K/DOQI ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Medical sciences ; Metabolism ; Mortality ; Naphthalenes - therapeutic use ; parathyroid hormone ; Parathyroid Hormone - blood ; Parathyroid Hormone - secretion ; Parathyroidectomy ; Pathogenesis ; Peritoneal dialysis ; Pharmacology. Drug treatments ; Phosphorus ; Phosphorus - blood ; Renal Dialysis</subject><ispartof>Clinical therapeutics, 2004-12, Vol.26 (12), p.1976-1993</ispartof><rights>2004 Excerpta Medica, Inc.</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c493t-9be1b43f5b3380888232d4798afc0804a7c3bb6ae5f9889a860e080e031891333</citedby><cites>FETCH-LOGICAL-c493t-9be1b43f5b3380888232d4798afc0804a7c3bb6ae5f9889a860e080e031891333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0149291804000815$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16465264$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15823762$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Francisco, Angel L.M.</creatorcontrib><title>Secondary hyperparathyroidism: Review of the disease and its treatment</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description>Most patients with chronic kidney disease (CKD) stage 5 develop secondary hyperparathyroidism (SHPT). SHPT is an adaptive response to CKD and its associated disruptions in the homeostatic control of serum phosphorus, calcium, and vitamin D. The poor control of mineral and parathyroid hormone (PTH) levels characteristic of SHPT is associated with serious clinical consequences.
This review discusses the pathophysiology and consequences of SHPT, as well as the efficacy and limitations of current treatment modalities.
Literature searches were conducted using the MEDLINE, EMBASE, and BIOSIS databases. Additional information was obtained from Internet web sites, textbooks, and nephrology congress abstracts.
Patients with uncontrolled SHPT are at higher risk for cardiovascular morbidity and mortality, hospitalization, bone disease, vascular and soft-tissue calcification, and vascular access failure than patients whose mineral and PTH levels are well managed. New National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) targets for calcium, phosphorus, calcium-phosphorus product, and PTH control have recently been published with the aim of improving the management of mineral metabolism in CKD patients. Data from observational studies suggest that the majority of patients currently have PTH and mineral levels outside these target ranges.
Given the inadequacies of current therapies, novel agents are being developed that may help improve the management of SHPT.</description><subject>Aluminum</subject><subject>Biological and medical sciences</subject><subject>Bone diseases</subject><subject>Calcification</subject><subject>calcium</subject><subject>Calcium - blood</subject><subject>calcium-phosphorus product</subject><subject>chronic kidney disease</subject><subject>Cinacalcet Hydrochloride</subject><subject>Fractures</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Hyperparathyroidism, Secondary - etiology</subject><subject>Hyperparathyroidism, Secondary - physiopathology</subject><subject>Hyperparathyroidism, Secondary - therapy</subject><subject>Hyperplasia</subject><subject>K/DOQI</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Mortality</subject><subject>Naphthalenes - therapeutic use</subject><subject>parathyroid hormone</subject><subject>Parathyroid Hormone - blood</subject><subject>Parathyroid Hormone - secretion</subject><subject>Parathyroidectomy</subject><subject>Pathogenesis</subject><subject>Peritoneal dialysis</subject><subject>Pharmacology. Drug treatments</subject><subject>Phosphorus</subject><subject>Phosphorus - blood</subject><subject>Renal Dialysis</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkF1LHDEUhkOx1K32L7QD0t7NmJNkMknvFqlaEARboXchkznDZpmPbZJV9t8b2UXBG68OHJ73nJeHkG9AK6Agz9eVG_yUVhhsxSgVFbCKAnwgC1CNLgHEvyOyoCB0yTSoY_I5xjWllOuafSLHUCvGG8kW5PIPunnqbNgVq90Gw8YGm1a7MPvOx_FncYcPHh-LuS_ysyLv0EYs7NQVPsUiBbRpxCmdko-9HSJ-OcwTcn_56-_FdXlze_X7YnlTOqF5KnWL0Are1y3niiqVW7BONFrZ3lFFhW0cb1tpse61UtoqSTHvkXJQGjjnJ-TH_u4mzP-3GJMZfXQ4DHbCeRuNbFgjdaMyePYGXM_bMOVuBihnmgmuZaaaPeXCHGPA3myCH7OMDJln0WZtXkSbZ9EGmMmic_Lr4f62HbF7zR3MZuD7AbDR2aEPdnI-vnJSyJpJkbnlnsOsLbsOJjqPk8POB3TJdLN_t8wTI5me3w</recordid><startdate>20041201</startdate><enddate>20041201</enddate><creator>de Francisco, Angel L.M.</creator><general>EM Inc USA</general><general>Excerpta Medica</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20041201</creationdate><title>Secondary hyperparathyroidism: Review of the disease and its treatment</title><author>de Francisco, Angel L.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-9be1b43f5b3380888232d4798afc0804a7c3bb6ae5f9889a860e080e031891333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aluminum</topic><topic>Biological and medical sciences</topic><topic>Bone diseases</topic><topic>Calcification</topic><topic>calcium</topic><topic>Calcium - blood</topic><topic>calcium-phosphorus product</topic><topic>chronic kidney disease</topic><topic>Cinacalcet Hydrochloride</topic><topic>Fractures</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Hyperparathyroidism, Secondary - etiology</topic><topic>Hyperparathyroidism, Secondary - physiopathology</topic><topic>Hyperparathyroidism, Secondary - therapy</topic><topic>Hyperplasia</topic><topic>K/DOQI</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Mortality</topic><topic>Naphthalenes - therapeutic use</topic><topic>parathyroid hormone</topic><topic>Parathyroid Hormone - blood</topic><topic>Parathyroid Hormone - secretion</topic><topic>Parathyroidectomy</topic><topic>Pathogenesis</topic><topic>Peritoneal dialysis</topic><topic>Pharmacology. Drug treatments</topic><topic>Phosphorus</topic><topic>Phosphorus - blood</topic><topic>Renal Dialysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Francisco, Angel L.M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Francisco, Angel L.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Secondary hyperparathyroidism: Review of the disease and its treatment</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2004-12-01</date><risdate>2004</risdate><volume>26</volume><issue>12</issue><spage>1976</spage><epage>1993</epage><pages>1976-1993</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>Most patients with chronic kidney disease (CKD) stage 5 develop secondary hyperparathyroidism (SHPT). SHPT is an adaptive response to CKD and its associated disruptions in the homeostatic control of serum phosphorus, calcium, and vitamin D. The poor control of mineral and parathyroid hormone (PTH) levels characteristic of SHPT is associated with serious clinical consequences.
This review discusses the pathophysiology and consequences of SHPT, as well as the efficacy and limitations of current treatment modalities.
Literature searches were conducted using the MEDLINE, EMBASE, and BIOSIS databases. Additional information was obtained from Internet web sites, textbooks, and nephrology congress abstracts.
Patients with uncontrolled SHPT are at higher risk for cardiovascular morbidity and mortality, hospitalization, bone disease, vascular and soft-tissue calcification, and vascular access failure than patients whose mineral and PTH levels are well managed. New National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) targets for calcium, phosphorus, calcium-phosphorus product, and PTH control have recently been published with the aim of improving the management of mineral metabolism in CKD patients. Data from observational studies suggest that the majority of patients currently have PTH and mineral levels outside these target ranges.
Given the inadequacies of current therapies, novel agents are being developed that may help improve the management of SHPT.</abstract><cop>Belle Mead, NJ</cop><pub>EM Inc USA</pub><pmid>15823762</pmid><doi>10.1016/j.clinthera.2004.12.011</doi><tpages>18</tpages></addata></record> |
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| ispartof | Clinical therapeutics, 2004-12, Vol.26 (12), p.1976-1993 |
| issn | 0149-2918 1879-114X |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aluminum Biological and medical sciences Bone diseases Calcification calcium Calcium - blood calcium-phosphorus product chronic kidney disease Cinacalcet Hydrochloride Fractures Glomerular Filtration Rate - physiology Hemodialysis Humans Hyperparathyroidism, Secondary - etiology Hyperparathyroidism, Secondary - physiopathology Hyperparathyroidism, Secondary - therapy Hyperplasia K/DOQI Kidney diseases Kidney Failure, Chronic - complications Kidney Failure, Chronic - mortality Kidney Failure, Chronic - therapy Medical sciences Metabolism Mortality Naphthalenes - therapeutic use parathyroid hormone Parathyroid Hormone - blood Parathyroid Hormone - secretion Parathyroidectomy Pathogenesis Peritoneal dialysis Pharmacology. Drug treatments Phosphorus Phosphorus - blood Renal Dialysis |
| title | Secondary hyperparathyroidism: Review of the disease and its treatment |
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