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Clinical and Experimental Nephrology

, Volume 11, Issue 4, pp 261–268 | Cite as

CKD-MBD: impact on management of kidney disease

  • Hiroaki OgataEmail author
  • Fumihiko Koiwa
  • Eriko Kinugasa
  • Tadao Akizawa
REVIEW ARTICLE

Abstract

Chronic kidney disease (CKD) causes various bone mineral disorders, which have recently been named CKD mineral and bone disorder (CKD-MBD). CKD-MBD is associated with extremely high cardiovascular disease (CVD) morbidity and mortality in the endstage kidney disease (ESKD) population. Thus, optimal management of CKD-MBD would lead to a reduction in cardiovascular morbidity and mortality in uremic patients. In addition, it has been suggested that the treatment of CKD-MBD has some favorable effects on the progression of CKD. Recently, novel therapeutic agents, including active vitamin D analogues, noncalcium-containing phosphate binders, and cinacalcet, have become clinically available. In this article, we review novel therapeutic strategies for CKD-MBD.

Key words

CKD CKD-MBD Cardiovascular disease Vitamin D Mineral metabolism 

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References

  1. 1.
    Ogata, H, Koiwa, F, Ito, H, Kinugasa, E 2006Therapeutic strategies for secondary hyperparathyroidism in dialysis patientsTher Apher Dial1035564CrossRefPubMedGoogle Scholar
  2. 2.
    Fukagawa, M, Akizawa, T 2006Calcium abnormalities of dialysis patientsJ Bone Miner Metab24160CrossRefPubMedGoogle Scholar
  3. 3.
    Cunningham, J 2005Management of secondary hyperparathyroidismTher Apher Dial9S3540CrossRefPubMedGoogle Scholar
  4. 4.
    National Kidney Foundation2003K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney diseaseAm J Kidney Dis42S1S201Google Scholar
  5. 5.
    The guideline committee of the Japanese Society for Dialysis Therapy2006Guidelines for the management of secondary hyperparathyroidism in chronic dialysis patientsJ Jpn Soc Dial Ther39143555CrossRefGoogle Scholar
  6. 6.
    Patient Registration Committee. An overview of regular dialysis treatment in Japan as of Dec. 31, 2004. Tokyo: Japanese Society for Dialysis Therapy; 2005Google Scholar
  7. 7.
    Young, EW, Albert, JM, Satayathum, S, Goodkin, DA, Pisoni, RL, Akiba, T,  et al. 2005Predictors and consequence of altered mineral metabolism: the dialysis outcomes practice pattern studyKidney Int67117987CrossRefPubMedGoogle Scholar
  8. 8.
    Moe, S, Drueke, T, Cunningham, J, Goodman, W, Martin, K, Olgaard, K,  et al. 2006Definition, evolution, and classification of renal osteodystrophy. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)Kidney Int69194553CrossRefPubMedGoogle Scholar
  9. 9.
    Foley, RN, Parfrey, PS, Sarnak, MJ 1998Epidemiology of cardiovascular disease in chronic renal diseaseJ Am Soc Nephrol9S1623PubMedGoogle Scholar
  10. 10.
    Block, GA, Hulbert-Shearon, TE, Levin, NW, Port, FK 1998Association of serum phosphorus and calcium × phosphate product with mortality risk in chronic hemodialysis patients: a national studyAm J Kidney Dis3160717CrossRefPubMedGoogle Scholar
  11. 11.
    Ganesh, SK, Stack, AG, Levin, NW, Hulbert-Shearon, T, Port, FK 2001Association of elevated serum PO(4), Ca × PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patientsJ Am Soc Nephrol1221318PubMedGoogle Scholar
  12. 12.
    Marco, MP, Craver, L, Betriu, A, Belart, M, Fibla, J, Fernandez, E 2003Higher impact of mineral metabolism on cardiovascular mortality in a European hemodialysis populationKidney Int85S1114CrossRefGoogle Scholar
  13. 13.
    Block, GA, Klassen, PS, Lazarus, JM, Ofsthum, N, Lowrie, EG, Chertow, GM 2004Mineral metabolism, mortality, and morbidity in maintenance hemodialysisJ Am Soc Nephrol15220818CrossRefPubMedGoogle Scholar
  14. 14.
    Avram, MM, Sreedhara, R, Avram, DK, Muchnick, RA, Fein, P 1996Enrollment parathyroid hormone level is a new marker of survival in hemodialysis and peritoneal dialysis therapy for uremiaAm J Kidney Dis2892430CrossRefPubMedGoogle Scholar
  15. 15.
    Avram, MM, Mittman, N, Myint, MM, Fein, P 2001Importance of low serum intact parathyroid hormone as a predictor of mortality in hemodialysis and peritoneal dialysis patients: 14 years of prospective observationAm J Kidney Dis3813517CrossRefPubMedGoogle Scholar
  16. 16.
    Melamed, ML, Eustace, JA, Plantinga, L, Jaar, BG, Fink, NE, Coresh, J,  et al. 2006Changes in serum calcium, phosphate, and PTH and the risk of death in incident dialysis patients: a longitudinal studyKidney Int703517CrossRefPubMedGoogle Scholar
  17. 17.
    Amann, K, Tornig, J, Kugel, B, Gross, ML, Tyralla, K, El-shakmak, A,  et al. 2003Hyperphosphatemia aggravates cardiac fibrosis and microvascular disease in experimental uremiaKidney Int631296301CrossRefPubMedGoogle Scholar
  18. 18.
    Neves, KR, Graciolli, FG, Dos Reis, LM, Pasqualucci, CA, Moyses, RM, Jorgetti, V 2004Adverse effects of hyperphosphatemia on myocardial hypertrophy, renal function, and bone in rats with renal failureKidney Int66223744CrossRefPubMedGoogle Scholar
  19. 19.
    Jolma, P, Kööbi, P, Kalliovalkama, J, Sara, H, Fan, M, Jokihaara, J,  et al. 2003Treatment of secondary hyperparathyroidism by high calcium diet is associated with enhanced resistance artery relaxation in experimental renal failureNephrol Dial Transplant1825609CrossRefPubMedGoogle Scholar
  20. 20.
    Kööbi, P, Vehmas, TI, Jolma, P, Kalliovalkama, J, Fan, M, Niemelä, O,  et al. 2006High-calcium vs high-phosphate intake and small artery tone in advanced experimental renal insufficiencyNephrol Dial Transplant21275461CrossRefPubMedGoogle Scholar
  21. 21.
    Slatopolsky, E, Brown, A, Dusso, A 1999Pathogenesis of secondary hyperparathyroidismKidney Int56S149CrossRefGoogle Scholar
  22. 22.
    Jono, S, McKee, M, Murry, CE, Shioi, A, Nishizawa, Y, Mori, K,  et al. 2000Phosphate regulation of vascular smooth muscle cell calcificationCirc Res87e107CrossRefPubMedGoogle Scholar
  23. 23.
    Ducy, P, Zhang, R, Geoffroy, V, Ridall, AL, Karsenty, G 1997Osf2/Cbfa1: a transcriptional activator of osteoblast differentiationCell8974754CrossRefPubMedGoogle Scholar
  24. 24.
    Reynolds, JL, Joannides, AJ, Skepper, JN, McNair, R, Schurgers, LJ, Proudfoot, D,  et al. 2004Human vascular smooth muscle cells undergo vesicle-mediated calcification in response to changes in extracellular calcium and phosphate concentrations: a potential mechanism for accelerated vascular calcification in ESRDJ Am Soc Nephrol15285767CrossRefPubMedGoogle Scholar
  25. 25.
    Boström, K, Watson, KE, Horn, S, Wortham, C, Herman, IM, Demer, LL 1993Bone morphogenetic protein expression in human artherosclerotic lesionsJ Clin Invest9118009CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Parhami, F, Basseri, B, Hwang, J, Tintut, Y, Demer, LL 2002High-density lipoprotein regulates calcification of vascular cellsCirc Res915706CrossRefPubMedGoogle Scholar
  27. 27.
    Shao, JS, Cheng, SL, Pingsterhaus, JM, Charlton-Kachigian, N, Loewy, AP, Towler, DA 2005Msx2 promotes cardiovascular calcification by activating paracrine Wnt signalsJ Clin Invest115121020CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Price, PA, Buckley, JR, Williamson, MK 2001The amino bisphosphonate ibandronate prevents vitamin D toxicity and inhibits vitamin-D-induced calcification of arteries, cartilage, lungs and kidneys in ratsJ Nutr13129105CrossRefPubMedGoogle Scholar
  29. 29.
    Amann K, Kronenberg G, Gehlen F, Wessels S, Orth S, Münter K, et al. Cardiac remodelling in experimental renal failure – an immunohistochemical study. 1998;13:1358–66Google Scholar
  30. 30.
    Amann K, Törnig J, Kugel B, Gross ML, Tyralla K, El-Shakmak A, et al. Hyperphosphatemia aggravates cardiac fibrosis and microvascular disease in experimental uremia. Kidney Int 63:1296–301Google Scholar
  31. 31.
    Nagano, N, Miyata, S, Obana, S, Kobayashi, N, Fukushima, N, Bruke, SK, Wada, M 2003Sevelamer hydrochloride, a phosphate binder, protects against deterioration of renal function in rats with progressive chronic renal insufficiencyNephrol Dial Transplant18201423CrossRefPubMedGoogle Scholar
  32. 32.
    Amann, K, Törnig, J, Flechtenmacher, C, Nabokov, A, Mall, G, Ritz, E 1995Blood-pressure-independent wall thickening of intramyocardial arterioles in experimental uraemia: evidence for a permissive action of PTHNephrol Dial Transplant1020438PubMedGoogle Scholar
  33. 33.
    Pajda, M, Matug, A, Widlak, M, Antoniak, K, Ficek, R, Chudek, J, Wiecek, A 2006Influence of parathyroidectomy on blood pressure and function of the transplanted kidney in patients with tertiary hyperparathyroidismAnn Transplant11115PubMedGoogle Scholar
  34. 34.
    Sato, S, Ohta, M, Kawaguchi, Y, Okada, H, Ono, M, Saito, H, Utsunomiya, M,  et al. 1995Effects of parathyroidectomy on left ventricular mass in patients with hyperparathyroidismMiner Electrolyte Metab216771PubMedGoogle Scholar
  35. 35.
    Haussler, MR, Whitfield, GK, Haussler, CA, Hsieh, JC, Thomson, PD, Selznick, SH,  et al. 1998The nuclear vitamin D receptor: Biological and molecular regulatory properties revealedJ Bone Miner Res1332549CrossRefPubMedGoogle Scholar
  36. 36.
    Sandgren, ME, Bronnegard, M, DeLuca, HF 1991Tissue distribution of the 1,25-dihydroxyvitamin D3 receptor in the male ratsBiochem Biophys Res Commun1816116CrossRefPubMedGoogle Scholar
  37. 37.
    Lin, R, White, JH 2003The pleiotropic actions of vitamin DBioEssays26218CrossRefGoogle Scholar
  38. 38.
    Pfeifer, M, Begerow, B, Minne, HW, Nachtigall, D, Hansen, C 2001Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly womenJ Clin Endocrinol Metab8616337PubMedGoogle Scholar
  39. 39.
    McCarron, DA, Morris, CD 1985Blood pressure response to oral calcium in persons with mild to moderate hypertension. A randomized, double-blind, placebo controlled, cross-over trialAnn Intern Med10382531CrossRefPubMedGoogle Scholar
  40. 40.
    Li, YC, Kong, J, Wei, M, Chen, ZF, Liu, SQ, Cao, LP 20021,25-Dihydroxyvitamin D3 is a negative endocrine regulator of the renin-angiotensin systemJ Clin Invest11022938CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Xiang, W, Kong, J, Chen, S, Cao, LP, Qiao, G, Zheng, W,  et al. 2005Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systemsAm J Physiol Endocrinol Metab28812532CrossRefGoogle Scholar
  42. 42.
    Parfrey, PS, Foley, RN, Harnett, JD, Kent, GM, Murray, DC, Barre, PE 1996Outcome and risk factors for left ventricular disorders in chronic uraemiaNephrol Dial Transplant11127785CrossRefPubMedGoogle Scholar
  43. 43.
    Silberberg, JS, Barre, PE, Prichard, SS, Sniderman, AD 1989Impact of LVH on survival in end-stage renal diseaseKidney Int3628690CrossRefPubMedGoogle Scholar
  44. 44.
    Stack, AG, Saran, R 2002Clinical correlates and mortality impact of left ventricular hypertrophy among new ESRD patients in the United StatesAm J Kidney Dis40120210CrossRefPubMedGoogle Scholar
  45. 45.
    Weishaar, RE, Kim, SN, Saunders, DE, Simpson, RU 1990Involvement of vitamin D3 with cardiovascular function III. Effects on physical and morphological propertiesAm J Physiol258E13442PubMedGoogle Scholar
  46. 46.
    Achinger, SG, Ayus, JC 2005The role of vitamin D in left ventricular hypertrophy and cardiac functionKidney Int67S3742CrossRefGoogle Scholar
  47. 47.
    O'Connell TD, Berry JE, Jarvis AK, Somerman MJ, Simpson RU. 1,25-Dehydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy 1997;272:H1751–8Google Scholar
  48. 48.
    Wu, J, Garami, M, Cheng, T, Gardner, DG 19971,25 (OH)2 vitamin D3, and retinoic acid antagonized endothelin-stimulated hypertrophy of neonatal rat cardiac myocytesJ Clin Invest97157788CrossRefGoogle Scholar
  49. 49.
    Park, CW, Oh, YS, Shin, YS, Kim, CM, Kim, YS, Choi, EJ,  et al. 1999Intravenous calcitriol regresses myocardial hypertrophy in hemodialysis patients with secondary hyperparathyroidismAm J Kidney Dis333781CrossRefGoogle Scholar
  50. 50.
    Kinugasa, E, Koshikawa, S 2001Effects of PB-94 (sevelamer hydrochloride), a phosphate binder, on the treatment of hyperphosphatemia in hemodialysis. A randomized, open label, dose-titration study of PB-94 versus Caltan (abstract)J Am Soc Nephrol12755AGoogle Scholar
  51. 51.
    Tahara, H, Tsujimoto, Y, Shoji, T, Inaba, M, Tabata, T, Nishizawa, Y 2005Induction of sevelamer hydrochloride and its clinical effectsTher Apher Dial9S26CrossRefPubMedGoogle Scholar
  52. 52.
    Katsumata, K, Kusano, K, Hirata, M, Tsunemi, K, Nagano, N, Brucke, SK, Fukushima, N 2003Sevelamer hydrochloride prevents ectopic calcification and renal osteodystrophy in chronic renal failure ratsKidney Int6444150CrossRefPubMedGoogle Scholar
  53. 53.
    Chertow, GM Burke, SK Reggi, P Treat to Goal Working Group2002Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patientsKidney Int6224552CrossRefPubMedGoogle Scholar
  54. 54.
    Nagano, N, Miyata, S, Obana, S, Kobayashi, N, Fukushima, N, Burke, SK, Wada, M 2003Sevelamer hydrochloride, a phosphate binder, protects against deterioration of renal function in rats with progressive chronic renal insufficiencyNephrol Dial Transplant18201423CrossRefPubMedGoogle Scholar
  55. 55.
    Cozzolino, M, Staniforth, ME, Liapis, H, Finch, J, Burke, SK, Dusso, AS, Slatopolsky, E 2003Sevelamer hydrochloride attenuates kidney and cardiovascular calcifications in long-term experimental uremiaKidney Int64165361CrossRefPubMedGoogle Scholar
  56. 56.
    Cozzolino, M, Dusso, AS, Liapis, H, Finch, J, Lu, Y, Burke, SK, Slatopolsky, E 2002The effects of sevelamer hydrochloride and calcium carbonate on kidney calcification in uremic ratsJ Am Soc Nephrol132299308CrossRefPubMedGoogle Scholar
  57. 57.
    De Santo, NG, Frangiosa, A, Anastasio, P, Marino, A, Correale, G, Perna, A,  et al. 2006Sevelamer worsens metabolic acidosis in hemodialysis patientsJ Nephrol19S10814PubMedGoogle Scholar
  58. 58.
    Duggal, A, Hanus, M, Zhorov, E, Dagher, R, Plone, MA, Goldberg, J, Bruke, SK 2006Novel dosage forms and regimens for sevelamer-based phosphate bindersJ Ren Nutr1624852CrossRefPubMedGoogle Scholar
  59. 59.
    Hutchison, AJ, Speake, M, Al-Baaj, F 2004Reducing high phosphate levels in patients with chronic renal failure undergoing dialysis: a 4-week, dose-finding, open-label study with lanthanum carbonateNephrol Dial Transplant1919026CrossRefPubMedGoogle Scholar
  60. 60.
    Lacour, B, Lucas, A, Auchere, D, Ruellan, N, de Serre Patey, NM, Drücke, TB 2005Chronic renal failure is associated with increased tissue deposition of lanthanum after 28-day oral administrationKidney Int6710629CrossRefPubMedGoogle Scholar
  61. 61.
    Hutchison, AJ, Maes, B, Vanwalleghem, J, Asmus, G, Mohamed, E, Schmieder, R,  et al. 2006Long-term efficacy and tolerability of lanthanum carbonate: results from a 3-year studyNephrol Clin Pract102c617CrossRefGoogle Scholar
  62. 62.
    Akizawa, T, Ohashi, Y, Akiba, T, Suzuki, M, Nishizawa, Y, Ogata, E,  et al. 2004Dose-response study of 22-oxacalcitriol in patients with secondary hyperparathyroidismTher Apher Dial848091CrossRefPubMedGoogle Scholar
  63. 63.
    Brown, AJ, Dusso, A, Slatopolsky, E 2002Vitamin D analogues for secondary hyperparathyroidismNephrol Dial Transplant17109CrossRefPubMedGoogle Scholar
  64. 64.
    Shoji, T, Shinohara, K, Kimoto, E, Emoto, M, Tahara, H, Koyama, H,  et al. 2004Lower risk for cardiovascular mortality in oral 1 alpha-hydroxy vitamin D3 users in a haemodialysis populationNephrol Dial Transplant1917984CrossRefPubMedGoogle Scholar
  65. 65.
    Teng, M, Wolf, M, Lowrie, E, Ofsthun, N, Lazarus, JM, Thadhani, R 2003Survival of patients undergoing hemodialysis with paricalcitol or calcitriol therapyN Engl J Med34944656CrossRefPubMedGoogle Scholar
  66. 66.
    Tentori, F, Hunt, WC, Stidley, CA, Rohrscheib, MR, Bedrick, EJ, Meyer, KB,  et al. 2006Mortality risk among hemodialysis patients receiving different vitamin D analogsKidney Int70185865CrossRefPubMedGoogle Scholar
  67. 67.
    Schwarz, U, Amann, K, Orth, SR, Simonaviciene, A, Wessels, S, Ritz, E 1998Effect of 1,25 (OH)2 vitamin D3 on glomerulosclerosis in subtotally nephrectomized ratsKidney Int531696705CrossRefPubMedGoogle Scholar
  68. 68.
    Branisteanu, DD, Leenaert, P, van Damme, B, Bouillon, R 1993Partial prevention of active Heymann nephritis by 1α,25 dihydroxyvitamin D3Clin Exp Immunol944127CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Hirata, M, Makibayashi, K, Katsumata, K,  et al. 200222-Oxacalcitriol prevents progressive glomerulosclerosis without adversely affecting calcium and phosphorus metabolism in subtotally nephrectomized ratsNephrol Dial Transplant1721327CrossRefPubMedGoogle Scholar
  70. 70.
    Makibayashi, K, Tatematsu, M, Hirata, M, Fukushima, N, Kusano, K, Ohashi, S,  et al. 2001A vitamin D analog ameliorates glomerular injury on rat glomerulonephritisAm J Pathol158173341CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Panichi, V, Migliori, M, Taccola, D, Filippi, C, De Nisco, L, Giovannini, L,  et al. 2001Effects of 1,25 (OH) 2D3 in experimental mesangial proliferative nephritis in ratsKidney Int608795CrossRefPubMedGoogle Scholar
  72. 72.
    Krit, W, Lemley, KV 1999The role of the podocyte in glomerulosclerosisCurr Opin Nephrol Hypertens848997CrossRefGoogle Scholar
  73. 73.
    Kuhlmann, A, Haas, CS, Gross, ML, Reulbach, U, Holzinger, M, Schwarz, U,  et al. 20041,25-Dihydroxyvitamin D3 decreases podocyte loss and podocyte hypertrophy in the subtotally nephrectomized ratAm J Physiol Renal Physiol286F52633CrossRefPubMedGoogle Scholar
  74. 74.
    Block, GA, Martin, KJ, de Francisco, AL, Turner, SA, Avram, MM, Suranyi, MG,  et al. 2004Cinacalcet for secondary hyperparathyroidism in patients receiving hemodialysisN Engl J Med350151625CrossRefPubMedGoogle Scholar
  75. 75.
    Mizobuchi, M, Hatamura, I, Ogata, H, Saji, F, Uda, S, Shiizaki, K,  et al. 2004Calcimimetic compound upregulates decreased calcium-sensing receptor expression level in parathyroid glands of rats with chronic renal insufficiencyJ Am Soc Nephrol15257987CrossRefPubMedGoogle Scholar
  76. 76.
    Wada, M, Ishii, H, Furuya, Y, Fox, J, Nemeth, EF, Nagano, N 1998NPS R-568 halts or reverses osteitis fibrosa in uremic ratsKidney Int5344853CrossRefPubMedGoogle Scholar
  77. 77.
    Ishii, H, Wada, M, Furuya, Y, Nagano, N, Nemeth, EF, Foz, J 2000Daily intermittent decreases in serum levels of parathyroid hormone have an anabolic-like action on the bones of uremic rats with low-turnover and osteomalaciaBone2617182CrossRefGoogle Scholar
  78. 78.
    Odenwald, T, Nakagawa, K, Hadtstein, C, Roesch, F, Gohlke, P, Ritz, E,  et al. 2006Acute blood pressure effects and chronic hypotensive action of calcimimetics in uremic ratsJ Am Soc Nephrol1765562CrossRefPubMedGoogle Scholar
  79. 79.
    Ogata, H, Ritz, E, Odoni, G, Amann, K, Orth, SR 2003Beneficial effects of calcimimetics on progression of renal failure and cardiovascular risk factorsJ Am Soc Nephrol1495967CrossRefPubMedGoogle Scholar
  80. 80.
    Brown, EM, Pollak, M, Hebert, SC 1998The extracellular calcium-sensing receptor: its role in health and diseaseAnnu Rev Med491529CrossRefPubMedGoogle Scholar
  81. 81.
    Nagano, N 2005Pharmacological and clinical properties of calcimimetics: calcium receptor activators that afford an innovative approach to controlling hyperparathyroidismPharmacol Ther10933965CrossRefPubMedGoogle Scholar
  82. 82.
    Lindberg, JS, Moe, SM, Goodman, WG, Coburn, JW, Sprague, SM, Li, W,  et al. 2003The calcimimetic AMG 073 reduces parathyroid hormone and calcium × phosphorus in secondary hyperparathyroidismKidney Int6324854CrossRefPubMedGoogle Scholar
  83. 83.
    Quarles, LD, Sherrard, DJ, Adler, S, Rosansky, SJ, McCary, LC, Liu, W,  et al. 2003The calcimimetic AMG073 as a potential treatment for secondary hyperparathyroidism of end-stage renal diseaseJ Am Soc Nephrol1457583CrossRefPubMedGoogle Scholar
  84. 84.
    Moe, SM, Chertow, GM, Coburn, JW, Quarles, LD, Goodman, WG, Block, GA,  et al. 2005Achieving NKF-K/DOQI bone metabolism and disease goals with cinacalcet HClKidney Int6776071CrossRefPubMedGoogle Scholar
  85. 85.
    Cunningham, J, Danese, M, Olson, K, Klassen, P, Chertow, GM 2005Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidismKidney Int681793800CrossRefPubMedGoogle Scholar
  86. 86.
    Lien, YH, Sliva, A, Whittman, D 2005Effects of cinacalcet on bone mineral density in patients with secondary hyperparathyroidismNephrol Dial Transplant2012327CrossRefPubMedGoogle Scholar
  87. 87.
    Lopez, I, Aguilera-Tejero, E, Mendoza, FJ, Almaden, Y, Perez, J, Martin, D, Rodriguez, M 2006Calcimimetic R-568 decreases extraosseous calcifications in uremic rats treated with calcitriolJ Am Soc Nephrol17795804CrossRefPubMedGoogle Scholar
  88. 88.
    Charytan, C, Coburn, JW, Chonchol, M, Herman, J, Lien, YH, Liu, W,  et al. 2005Cinacalcet hydrochloride is an effective treatment for secondary hyperparathyroidism in patients with CKD not receiving dialysisAm J Kidney Dis465867CrossRefPubMedGoogle Scholar
  89. 89.
    Fukagawa, M, Kazama, JJ, Shigematsu, T 2002Management of patients with advanced secondary hyperparathyroidism: the Japanese approachNephrol Dial Transplant1715537CrossRefPubMedGoogle Scholar
  90. 90.
    Koiwa, F, Kakuta, T, Tanaka, R, Yumita, S 2007Efficacy of percutaneous ethanol injection therapy (PEIT) is related to the number of parathyroid glands in haemodialysis patients with secondary hyperparathyroidismNephrol Dial Transplant225228CrossRefPubMedGoogle Scholar
  91. 91.
    Shiizaki, K, Negi, S, Hatamura, I, Sakaguchi, T, Saji, F, Kunimoto, K,  et al. 2005Biochemical and cellular effects of direct maxacalcitol injection into parathyroid gland in uremic ratsJ Am Soc Nephrol1697108CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2007

Authors and Affiliations

  • Hiroaki Ogata
    • 1
    Email author
  • Fumihiko Koiwa
    • 2
  • Eriko Kinugasa
    • 1
  • Tadao Akizawa
    • 3
  1. 1.Department of Internal MedicineShowa University Northern Yokohama HospitalYokohamaJapan
  2. 2.Division of Nephrology, Department of Internal MedicineShowa University Fujigaoka HospitalYokohamaJapan
  3. 3.Department of NephrologyShowa University School of MedicineTokyoJapan

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