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Drug Insight: renal indications of calcimimetics

Nature Clinical Practice Nephrology volume 2, pages 316–325 (2006)Cite this article

Abstract

Calcimimetics suppress the secretion of parathyroid hormone by sensitizing the parathyroid calcium receptor to serum calcium. Cinacalcet (Sensipar®/Mimpara®, Amgen Inc., Thousand Oaks, CA), the first-in-class calcimimetic agent approved for treatment of secondary hyperparathyroidism in dialysis patients, is, in association with higher dose of a calcium-based oral phosphate binder, a well-tolerated and effective alternative to standard treatments such as vitamin D derivatives in association with a non-calcium-based oral phosphate binder. Here, we present an overview of evidence in support of this assertion. We extend our discussion to encompass other indications for calcimimetics—secondary hyperparathyroidism in predialysis chronic kidney disease patients, hypercalcemic hyperparathyroidism in renal transplant recipients, primary hyperparathyroidism, and hypercalcemia associated with parathyroid carcinoma—as well as providing guidance on optimal usage of this drug.

Key Points

  • Calcimimetic drugs such as cinacalcet (Sensipar®/Mimpara®, Amgen Inc., Thousand Oaks, CA) suppress secretion of parathyroid hormone by sensitizing calcium receptors to extracellular ionized calcium

  • Cinacalcet has been approved for treatment of dialysis patients with secondary hyperparathyroidism

  • Cinacalcet is a safe, efficacious and cost-effective alternative to currently recommended drug regimens (e.g. vitamin D derivatives plus non-calcium-based oral phosphate binders)

  • Some data support use of calcimimetics to manage predialysis secondary hyperparathyroidism, hypercalcemic hyperparathyroidism in kidney graft recipients, primary hyperparathyroidism and parathyroid carcinoma

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Author information

Authors and Affiliations

  1. Department of Nephrology Internal Medicine Intensive Care, all in the Department of Nephrology Internal Medicine, Amiens University Hospital, Jules Verne University of Picardy, France

    Irina Shahapuni, Matthieu Monge, Hakim Mazouz, Pierre-François Westeel, Philippe Morinière, Gabriel Choukroun & Albert Fournier

  2. Geriatrics Department, Amiens University Hospital, Jules Verne University of Picardy, France

    Roxana Oprisiu

  3. nephrology consultant, and Professor of Pharmacology and Director of INSERM ERI-12, Amiens University Hospital, Jules Verne University of Picardy, France

    Ziad Massy

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  1. Irina Shahapuni
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Correspondence to Albert Fournier.

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Shahapuni, I., Monge, M., Oprisiu, R. et al. Drug Insight: renal indications of calcimimetics. Nat Rev Nephrol 2, 316–325 (2006). https://doi.org/10.1038/ncpneph0191

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  • DOI: https://doi.org/10.1038/ncpneph0191

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