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Calcitriol is a hormone and the active form of vitamin D, normally made in the kidney. [8] [9] [10] It is also known as 1,25-dihydroxycholecalciferol.It binds to and activates the vitamin D receptor in the nucleus of the cell, which then increases the expression of many genes. [11]
If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In people with chronic kidney failure, treatment consists of dietary restriction of phosphorus; supplements containing an active form of vitamin D, such as calcitriol, doxercalciferol, paricalcitol; and phosphate binders, which are either calcium-based and non-calcium based.
Renal osteodystrophy is usually diagnosed after treatment for end-stage kidney disease begins; however the CKD-MBD starts early in the course of CKD. [ 1 ] [ 6 ] In advanced stages, blood tests will indicate decreased calcium and calcitriol (vitamin D) and increased phosphate , and parathyroid hormone levels.
As a pharmaceutical drug, it is used as an injection to treat secondary hyperparathyroidism resulting from hemodialysis and as a topical ointment for psoriasis. [ 2 ] It was approved for use in Japan in 2010 [ 3 ] and in Taiwan in 2018.
Vitamin and mineral management for dialysis patients is a required treatment for people undergoing dialysis because during end-stage kidney disease and dialysis the kidneys are functioning at less than 15% of normal levels. [1] As a consequence, certain vitamin and mineral restrictions and supplementations are needed. [2]
[4] [12] Cinacalcet can also be used to treat severe hypercalcemia in patients with primary hyperparathyroidism who are unable to undergo parathyroidectomy. [4] [13] In the European Union cinacalcet is indicated for: the treatment of secondary hyperparathyroidism (HPT) in adults with end stage renal disease (ESRD) on maintenance dialysis ...
As a result, bone abnormalities are found almost universally in patients with CKD requiring dialysis (stage 5D), and in the majority of patients with CKD stages 3–5. [2] More recently, there has been an increasing concern of extraskeletal calcification that may result from the deranged mineral and bone metabolism of CKD and from the therapies ...
The natural, active form of vitamin D is calcitriol (1,25-dihydroxycholecalciferol). This molecule and other naturally occurring forms of vitamin D, including its precursors and metabolites, have been modified to synthesize pharmaceuticals with potentially greater, or selective, therapeutic actions. [1] [2] [3] [4]
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