Dataset Information

Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review.

ABSTRACT: Secondary hyperparathyroidism (SHPT) is an early complication and a well-known factor negatively affecting cardiovascular mortality already in the late stages of chronic kidney disease (CKD). Negative effects can also be foreseen in early stages of CKD.Set against this background, I performed detailed clinical review of the specific literature from 1975 on the various types of trials used to treat SHPT in order to assess their effect on uremic patients affected by CKD stage 3 stage 4.Out of the 1,820 papers reviewed, I identified 14 prospective controlled randomized trials involving in total 1,587 patients. Dietary approaches and the use of phosphorus chelating agents, either alone or in association, do not seem to be particularly promising for SHPT in uremic patients with CKD stage 3-4. Pending the publication of statistically wellstructured works on CKD stage 3-4, experience with calciummimetic agents in CKD stage 3-4 seems promising, even if there is a need to decrease the side effects most affecting medication compliance and as well safety calcium-mimetic agents seem to be more useful, especially in association with vitamin D derivatives. Further promising results seem to be provided by the latest generations of vitamin D derivatives such as paracalcitol which produces good SHPT control.

SUBMITTER: Bolasco P

PROVIDER: S-EPMC2811352 | biostudies-other | 2009 Sep

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review.

Bolasco Piergiorgio P

Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases 20090901 3

<h4>Unlabelled</h4>Secondary hyperparathyroidism (SHPT) is an early complication and a well-known factor negatively affecting cardiovascular mortality already in the late stages of chronic kidney disease (CKD). Negative effects can also be foreseen in early stages of CKD.<h4>Aim</h4>Set against this background, I performed detailed clinical review of the specific literature from 1975 on the various types of trials used to treat SHPT in order to assess their effect on uremic patients affected by ...[more]

PMID: 22461248

Similar Datasets

Project description:IntroductionSecondary hyperparathyroidism (SHPT) is a common and serious complication of chronic kidney disease (CKD). Elucidating the metabolic characteristics of SHPT may provide a new theoretical basis for its prevention and treatment. This study aimed to perform a metabolomic analysis of SHPT in patients with CKD stages 3-5 not receiving dialysis.MethodsA total of 76 patients with CKD, 85 patients with CKD-SHPT, and 67 healthy controls were enrolled in this study. CKD was diagnosed according to the criteria specified in the Kidney Disease Improving Global Outcomes 2012 guidelines. SHPT was diagnosed by experienced clinicians according to the Renal Disease Outcomes Quality Initiative Clinical Practice Guidelines. Serum renal function markers and the lipid profile were analyzed. Untargeted ultra performance liquid chromatography-tandem mass spectrometry was used to analyze the serum metabolites of patients with CKD and SHPT. Multivariate analysis of the data was performed using principal component analysis and partial least square discriminant analysis. Serum differential metabolites were identified and further characterized using databases. Pathway enrichment analysis was performed using the Kyoto Encyclopedia of Genes and Genomes database. Correlations between differential metabolites and clinical parameters were determined using the Spearman correlation.ResultsThe serum metabolomic profiles of patients with CKD with and without SHPT differed significantly. Differential metabolites were mainly enriched in the top four Kyoto Encyclopedia of Genes and Genomes pathways: phenylalanine, tyrosine, and tryptophan biosynthesis; sphingolipid metabolism; glycerophospholipid metabolism; and phenylalanine metabolism. In total, 31 differential metabolites were identified; of these, L-tryptophan and (R)-(+)-1-phenylethylamine were decreased, while other amino acids and their derivatives, uremia toxins, carnitine, and lipids, were increased significantly in patients with SHPT compared to those without. The 14 lipid metabolites were positively correlated with levels of Urea, serum creatinine, cystatin C, and triglycerides and negatively correlated with the estimated glomerular filtration rate and levels of total and high- and low-density lipoprotein cholesterol.DiscussionDisturbed amino acid and lipid metabolism were more apparent in patients with SHPT than in those without. This metabolomic profile of SHPT may provide a therapeutic foundation for its future clinical management.

Dataset Information

Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review.

Publications

Treatment options of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease stages 3 and 4: an historic review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets