Persistent uncertainties in optimal treatment approaches of secondary hyperparathyroidism and hyperphosphatemia in patients with chronic kidney disease.

IF 4.3 2区医学

Current Osteoporosis Reports Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI:10.1007/s11914-024-00881-3

Daniela Del Pilar Via Reque Cortes, Tilman B Drueke, Rosa Maria Affonso Moysés

{"title":"Persistent uncertainties in optimal treatment approaches of secondary hyperparathyroidism and hyperphosphatemia in patients with chronic kidney disease.","authors":"Daniela Del Pilar Via Reque Cortes, Tilman B Drueke, Rosa Maria Affonso Moysés","doi":"10.1007/s11914-024-00881-3","DOIUrl":null,"url":null,"abstract":"Purpose of review: This review is a critical analysis of treatment results obtained in clinical trials conducted in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT), hyperphosphatemia, or both.Recent findings: Patients with CKD have a high mortality rate. The disorder of mineral and bone metabolism (CKD-MBD), which is commonly present in these patients, is associated with adverse outcomes, including cardiovascular events and mortality. Clinical trials aimed at improving these outcomes by modifying CKD-MBD associated factors have most often resulted in disappointing results. The complexity of CKD-MBD, where many players are closely interconnected, might explain these negative findings. We first present an historical perspective of current knowledge in the field of CKD-MBD and then examine potential flaws of past and ongoing clinical trials targeting SHPT and hyperphosphatemia respectively in patients with CKD.","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":" ","pages":"441-457"},"PeriodicalIF":4.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Osteoporosis Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11914-024-00881-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/19 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: This review is a critical analysis of treatment results obtained in clinical trials conducted in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT), hyperphosphatemia, or both.

Recent findings: Patients with CKD have a high mortality rate. The disorder of mineral and bone metabolism (CKD-MBD), which is commonly present in these patients, is associated with adverse outcomes, including cardiovascular events and mortality. Clinical trials aimed at improving these outcomes by modifying CKD-MBD associated factors have most often resulted in disappointing results. The complexity of CKD-MBD, where many players are closely interconnected, might explain these negative findings. We first present an historical perspective of current knowledge in the field of CKD-MBD and then examine potential flaws of past and ongoing clinical trials targeting SHPT and hyperphosphatemia respectively in patients with CKD.

Abstract Image

查看原文本刊更多论文

慢性肾病患者继发性甲状旁腺功能亢进症和高磷血症的最佳治疗方法一直存在不确定性。

综述目的：本综述对慢性肾脏病（CKD）和继发性甲状旁腺功能亢进症（SHPT）、高磷血症或两者兼有的患者进行的临床试验所取得的治疗结果进行了批判性分析：最新发现：慢性肾脏病患者的死亡率很高。这些患者普遍存在的矿物质和骨代谢紊乱（CKD-MBD）与不良后果有关，包括心血管事件和死亡率。临床试验旨在通过改变与 CKD-MBD 相关的因素来改善这些结果，但结果往往令人失望。CKD-MBD 的复杂性可能是这些负面研究结果的原因，因为许多因素之间存在密切联系。我们首先从历史角度介绍了目前在 CKD-MBD 领域的知识，然后研究了过去和正在进行的分别针对 CKD 患者 SHPT 和高磷血症的临床试验的潜在缺陷。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Osteoporosis Reports ENDOCRINOLOGY & METABOLISM-

CiteScore

8.40

自引率

2.30%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.