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- Title
Management of Secondary Hyperparathyroidism in Chronic Kidney Disease: A Focus on the Elderly.
- Authors
Galassi, Andrea; Ciceri, Paola; Fasulo, Eliana; Carugo, Stefano; Cianciolo, Giuseppe; Cozzolino, Mario
- Abstract
Secondary hyperparathyroidism (SHPT) is a major complication of chronic kidney disease (CKD), responsible for skeletal and vascular damage with increased risk of bone fractures, cardiovascular events, and mortality. However, the optimal serum parathormone (PTH) levels for improving clinical outcomes remain uncertain. Treatment of SHPT is based on nutritional therapy, phosphate binders, vitamin D, and calcimimetics, but none of these interventions has ever been tested against placebo in randomized controlled trials. Treatment of SHPT in the elderly should consider the many peculiarities of aging in terms of physiopathology, quality of life, symptoms, subjective perception of disease, drug load, and the modifying effect of treatment on disease-related outcomes. Unfortunately, peculiarities of SHPT among elderly CKD patients are mainly unexplored. The present review aims to provide a reasonable merging of evidence regarding the management of SHPT in CKD, with more actual concepts on how to care for older patients.
- Subjects
HYPERPARATHYROIDISM treatment; HYPERPARATHYROIDISM; CHRONIC kidney failure complications; MORTALITY risk factors; ELDER care; AGING; BONES; CARDIOVASCULAR diseases risk factors; BONE fractures; HORMONE antagonists; PARATHYROID hormone; PATHOLOGICAL physiology; QUALITY of life; SERIAL publications; VITAMIN D; ATTITUDES toward illness; DISEASE risk factors
- Publication
Drugs & Aging, 2019, Vol 36, Issue 10, p885
- ISSN
1170-229X
- Publication type
Article
- DOI
10.1007/s40266-019-00696-3