Practical use of parenteral calcimimetics for severe secondary hyperparathyroidism. A case report

S. Khoroshilov, S. Besedin, A. Nikulin
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Abstract

Secondary hyperparathyroidism (SHPT) leads to bone disorders and cardiovascular complications in long-term dialysis patients. SHPT is caused by hyperphosphatemia. Abnormalities of calcium-sensing receptor (CaSR) are associated with the pathogenesis of SHPT. Clinical trials have shown that calcimimetics significantly reduce the risks of parathyroidectomy, bone fracture and cardiovascular hospitalization among long-term dialysis patients with SHPT. Etelcalcetide, a novel calcimimetic compound, acts as a direct CaSR agonist, restores the sensitivity of the CaSR in parathyroid cells, and decreases serum parathyroid hormone without inducing hypercalcemia or hyperphosphatemia. Etelcalcetide's properties allow it to be administered intravenously thrice weekly at the end of a hemodialysis treatment session improving medication adherence.
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急性继发性甲状旁腺功能亢进的实际应用。病例报告
继发性甲状旁腺功能亢进(SHPT)导致长期透析患者的骨骼疾病和心血管并发症。SHPT是由高磷血症引起的。钙敏感受体(CaSR)异常与SHPT的发病机制有关。临床试验表明,钙化剂可显著降低SHPT长期透析患者甲状旁腺切除术、骨折和心血管住院的风险。Etelcalcetide是一种新型的拟钙化化合物,作为直接的CaSR激动剂,恢复甲状旁腺细胞中CaSR的敏感性,降低血清甲状旁腺激素,而不引起高钙血症或高磷血症。依替卡肽的特性允许它在血液透析治疗结束时静脉注射,每周三次,改善药物依从性。
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