Recent developments in the management of secondary hyperparathyroidism

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Recent developments in the management of secondary hyperparathyroidism William G. Goodman Kidney International Volume 59, Issue 3, Pages 1187-1201 (March 2001) DOI: 10.1046/j.1523-1755.2001.0590031187.x Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 1 Traditional interventions designed to prevent and control excess parathyroid hormone (PTH) secretion in patients with chronic renal failure. VDR is vitamin D receptor. Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 2 Relative mortality risk according to quintiles for serum phosphorus concentrations in patients with end-stage renal disease treated with dialysis. (Adapted from7). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 3 The molecular structures of 1α,25-dihydroxyvitamin D3 (calcitriol); 22-oxa-1α,25-dihydroxyvitamin D3 (22-oxacalcitriol or OCT); 1α,hydroxyvitamin D2 (doxercalciferol); and 19-nor-1α,25-dihydroxyvitamin D2 (paricalcitol). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 4 Serum total calcium and phosphorus concentrations during 12 weeks of treatment with paricalcitol (solid lines) or placebo (dashed lines) in 78 hemodialysis patients with secondary hyperparathyroidism. Forty patients received paricalcitol and 38 were given placebo. Values are means ± SEM. (From59). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 5 Plasma PTH levels expressed as a percentage of pretreatment values in 99 hemodialysis patients with secondary hyperparathyroidism who were treated with doxercalciferol for 16 weeks. Patients were then randomly assigned to placebo therapy (? N = 51), or they continued treatment with doxercalciferol (□, N = 48). Plasma PTH levels rose promptly after doxercalciferol therapy was withdrawn in placebo-treated patients. Values are means ± SEM. (Adapted from64). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 6 Blood-ionized calcium concentrations (top panel) and plasma PTH levels (bottom panel) after initial doses of R-568 in 16 hemodialysis patients with secondary hyperparathyroidism. Values are means ± SEM. (Adapted from74). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 7 Plasma PTH levels (top panel) and serum total calcium concentrations (bottom panel) during 15 days of treatment with single daily oral doses of 100mg of R-568 in 16 hemodialysis patients with secondary hyperparathyroidism. Values are means ± SEM. (Adapted from75). Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Kidney International 2001 59, 1187-1201DOI: (10. 1046/j. 1523-1755 Kidney International 2001 59, 1187-1201DOI: (10.1046/j.1523-1755.2001.0590031187.x) Copyright © 2001 International Society of Nephrology Terms and Conditions