CINACALCET (SENSIPAR) Calcimimetic Agents in CKD | ESRD | Dialysis and Hemodialysis Patients

Patients with chronic kidney disease have special issues in regulating mineral metabolism.
The kidneys actively hold onto necessary minerals and excrete or get rid of minerals thought to be in excessive supply. Some of these minerals necessary for cellular functions include sodium, potassium, calcium and phosphorous.

The kidneys play a unique role in calcium regulation due to the fact that healthy kidneys activate a form of Vitamin D. Vitamin D in turn facilitates absorption of Calcium from the intestines from the food or from bones.

Other important glands in this metabolic system are the parathyroids. These small glands in the neck secrete a hormone called PTH or parathyroid hormone that boosts the absorption of calcium from the intestine or bones if the body is deemed to have too little calcium.

Patients with abnormal, or scarred kidneys do not make sufficient active Vitamin D. Chronic kidney disease (CKD) patients or end stage renal disease (ESRD) patients therefore may be deficient in calcium and have an elevated parathyroid level. This elevated PTH level is called secondary hyperparathyrodism.

There are several methods of helping to control mineral metabolism in ESRD and CKD patients. Some of these methods include diet, Vitamin D supplementation and drugs which help absorb excessive minerals from the intestine. A relatively new medication acts to help decrease parathyroid hormone production by making the parathyroid gland more sensitive to calcium. This new class of medication is called a calcimimetic because it mimics the effects of calcium on the parathyroid glands.

The articles reference below discuss calcimemetics in CKD and ESRD.

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