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Management of Secondary Hyperparathyroidism in Chronic Kidney Disease: A Focus on the Elderly
- Source :
- Drugs & Aging. 36:885-895
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
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 :
- medicine.medical_specialty
Disease
Placebo
law.invention
03 medical and health sciences
0302 clinical medicine
Quality of life
Randomized controlled trial
law
Vitamin D and neurology
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Medical nutrition therapy
Renal Insufficiency, Chronic
Intensive care medicine
Aged
Randomized Controlled Trials as Topic
business.industry
Age Factors
medicine.disease
Quality of Life
Hyperparathyroidism, Secondary
Secondary hyperparathyroidism
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Kidney disease
Subjects
Details
- ISSN :
- 11791969 and 1170229X
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Drugs & Aging
- Accession number :
- edsair.doi.dedup.....78c48be2baf2a441cbe04e3b61c6ebf1