Vitamin D receptor activation and survival in chronic kidney disease

摘要: Replacement of activated vitamin D has been the cornerstone therapy for secondary hyperparathyroidism (SHPT). Recent findings from several large observational studies have suggested that benefits receptor activators (VDRA) may extend beyond traditional parathyroid hormone (PTH)-lowering effect, and could result in direct cardiovascular metabolic benefits. The advent new analogs molecule widened our therapeutic armamentarium, but also made decisions more complicated. Treatment SHPT become even complex with arrival first calcium-sensing (CSR) agonist (cinacalcet hydrochloride) uncovering novel mechanisms responsible SHPT. We provide a brief overview physiology pathophysiology SHPT, focus on metabolism, discuss various practical aspects VDRA its reported association survival recent studies. A detailed discussion available agents is aimed at providing practicing physician clear understanding advantages or disadvantages individual medications. number open questions are analyzed, including present future roles CSR agonists 25(OH) replacement.