Abstract
Cinacalcet is the first and so far the only one medication from the group of calcimimetics, introduced in clinical praxis in 2004. It's unique mechanism, e.g. increasing the calcium receptor sensitivity, changed fundamentally algorithms of medical management of secondary hyperparathyroidism (SHPT), based previously on vitamin D medications.
During SHPT treatment, cinacalcet decreases both calcium and phosphorus levels. This effect is opposite to the effect of vitamin D compounds, what allows favourably combine medications from both groups.
The goals of cinacalcet SHPT treatment are to achieve the target range for calcium, phosphorus, parathyroid hormone (PTH) and for other bone metabolism markers, to normalize bone structure and indirectly, to decrease total and cardiovascular mortality and morbidity. The positive cinacalcet effect can be limited by its side effects: nausea, vomiting, hypocalcemia or PTH oversuppresion.