[Fragility Fractures in Hemodialysis Patients. Calcimimetics and fracture in hemodialysis patients.]

Calcimimetics are widely used for severe secondary hyperparathyroidism in hemodialysis patients. Two clinical studies showed that cinacalcet, one of calcimimetics, has possibility to reduce the risk of fracture in hemodialysis patients. Although the mechanism in which calcimimetics reduce the risk of fracture in hemodialysis patients remains unclear, improvement of severe secondary hyperparathyroidism may cause the reduction of fracture risk. However, the optimal intact PTH levels for reducing the risk of fracture in hemodialysis patients is not known. In addition, since calcium-sensing receptor also exists in bone, calcimimetics may have direct effects on bone.