Persistent uncertainties in optimal treatment approaches of secondary hyperparathyroidism and hyperphosphatemia in patients with chronic kidney disease.
Daniela Del Pilar Via Reque CortesTilman B DruekeRosa Maria Affonso MoysesPublished in: Current osteoporosis reports (2024)
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.
Keyphrases
- chronic kidney disease
- end stage renal disease
- cardiovascular events
- clinical trial
- coronary artery disease
- cardiovascular disease
- healthcare
- newly diagnosed
- randomized controlled trial
- prognostic factors
- ejection fraction
- risk factors
- type diabetes
- bone mineral density
- peritoneal dialysis
- risk assessment
- drug delivery
- body composition
- study protocol
- double blind
- weight loss
- glycemic control
- placebo controlled