Vol 5, No 4 (2012)
Poglądy, stanowiska, zalecenia, standardy i opinie
Published online: 2012-12-28
Availability of different therapeutic option in patients with secondary hyperthyroidism in Poland
Forum Nefrologiczne 2012;5(4):333-338.
Abstract
Secondary hyperparathyroidism (SHPT) is one of the
most common metabolic disturbances appearing with
different severity in patients with chronic kidney disease
stage 5 underwent chronic dialysis therapy. This statement
is supported by data from annually performed
survey in which basic calcium and phosphate metabolism
parameters are collected among reliable sample of
Polish dialysed patients. Simultaneously with this data
also informations showing availability of different drugs
which are necessary for SHPT therapy are gathered.
Unfortunately modern drugs inhibiting phosphate absorption
in gastrointestinal tract are used only in scarce
number of patients due to their high cost and lack of
reimbursement. Therefore therapy with calcium salts is
mainly carried out in this case. Nevertheless one have
to be remember that their use especially in high doses
may lead to the development of heart and vascular calicifications.
From vitamin D derivatives most commonly
alfadiol (1a-cholekalciferol) and calcifediol (25-hydroxyl-
vitamin D3) are used. On the other hand existence
of the therapeutic program enable quite satisfactory use
of calcimimetic (cinacalcet), which was used last year
in over 13% of dialysed patients. On the contrary other
modern drug inhibiting parathormon production and secretion
— vitamin D receptor blocker (paricalcitol) is not
widely available also due to financial constrains. Now
nephrological community is waiting with hope for the
decision of appropriate institutions considering subsequent
proposal enabling introduction of new therapeutic
programs letting use of the whole selection of drugs
which are necessary in the SHPT treatment.
most common metabolic disturbances appearing with
different severity in patients with chronic kidney disease
stage 5 underwent chronic dialysis therapy. This statement
is supported by data from annually performed
survey in which basic calcium and phosphate metabolism
parameters are collected among reliable sample of
Polish dialysed patients. Simultaneously with this data
also informations showing availability of different drugs
which are necessary for SHPT therapy are gathered.
Unfortunately modern drugs inhibiting phosphate absorption
in gastrointestinal tract are used only in scarce
number of patients due to their high cost and lack of
reimbursement. Therefore therapy with calcium salts is
mainly carried out in this case. Nevertheless one have
to be remember that their use especially in high doses
may lead to the development of heart and vascular calicifications.
From vitamin D derivatives most commonly
alfadiol (1a-cholekalciferol) and calcifediol (25-hydroxyl-
vitamin D3) are used. On the other hand existence
of the therapeutic program enable quite satisfactory use
of calcimimetic (cinacalcet), which was used last year
in over 13% of dialysed patients. On the contrary other
modern drug inhibiting parathormon production and secretion
— vitamin D receptor blocker (paricalcitol) is not
widely available also due to financial constrains. Now
nephrological community is waiting with hope for the
decision of appropriate institutions considering subsequent
proposal enabling introduction of new therapeutic
programs letting use of the whole selection of drugs
which are necessary in the SHPT treatment.
