[Vitamin D and its analogs in the treatment of secondary hyperparathyroidism (2nd HPT) associated with end stage renal disease (ESRD)].

Management of 2nd HPT in ESRD patients consists of administration of vitamin D (VD) and phosphate control. VD possesses not only suppressive effect on parathyroid hormone (PTH) secretion via increase in serum calcium, but also shows direct suppressive action on transcription of PTH mRNA and parathyroid cell growth, especially in high dose intermittent administratin (pulse therapy). However, hypercalcemia, a major side effect of VD pulse therapy, have limited the effective usage of VD, especially in patients with severe hyperparathyroidism. Several new VD analogs have been developed that specifically target parathyroid cells while having less calcemic action, and currently approved for clinical use.