Role of cinacalcet in management of mineral bone disorder in chronic kidney disease (control of calcium, phosphorus and parathyroid hormone).

The management of hemodialysis patients with chronic kidney disease-mineral bone disorder includes treatment to control levels of calcium, phosphorus and parathyroid hormone, so as to prevent bone and soft-tissue complications. Recently, pleiotropic effects of active vitamin D have attracted much attention, and its effect on outcome has also gained recognition. However, administration of active vitamin D may cause hypercalcemia and hyperphosphatemia. Now, the use of a novel class of drugs, cinacalcet hydrochloride, has been proposed as a strategy to reduce parathyroid hormone secretion, while decreasing levels of serum calcium, phosphorus, and calcium x phosphorus products. Among subjects with secondary hyperparathyroidism undergoing hemodialysis, combined therapy with cinacalcet and vitamin D sterols improved achievement of the biochemical targets for chronic kidney disease-mineral bone disorder recommended by the guidelines.