Abstract

POTENTIAL ROLE OF CALCIMIMETICS IN CKD – CLINICAL FINDINGS, AND THERAPEUTIC CHALLENGES

Glory Dsouza*, Leema Lobo and Dr. Manjari Sharma

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Abstract

Chronic Kidney Disease (CKD) is a global health concern characterized by progressive loss of renal function and associated mineral and bone disorders. Calcimimetics, a class of drugs primarily used in the management of secondary hyperparathyroidism (SHPT) in CKD, have garnered considerable attention for their multifaceted potential in improving the clinical outcomes of CKD patients. Calcimimetics such as cinacalcet and etelcalcetide act as allosteric modulators of the calcium-sensing receptor (CaSR), which plays a pivotal role in regulating parathyroid hormone (PTH) secretion. By enhancing the sensitivity of CaSR to extracellular calcium, calcimimetics effectively lower PTH levels, thus mitigating the hyperparathyroidism commonly observed in CKD patients. However, their benefits extend beyond PTH control. Studies have demonstrated that calcimimetics can ameliorate mineral and bone disturbances, such as hyperphosphatemia and vascular calcification, by regulating calcium and phosphorus homeostasis. Moreover, their potential to alleviate cardiovascular complications, enhance bone health, and improve overall survival rates in CKD patients undergoing dialysis has sparked interest in broader applications. These agents may confer renoprotective effects by reducing inflammation, oxidative stress, and fibrosis within the kidney. Additionally, calcimimetics may influence blood pressure regulation and vascular health, potentially addressing hypertension-related complications in CKD. Their multifaceted mechanisms of action, encompassing PTH control, mineral and bone regulation, and potential renoprotection, underscore their relevance in improving the clinical outcomes and quality of life for CKD patients. As ongoing research continues to unravel the full scope of their therapeutic potential, calcimimetics may emerge as valuable adjuncts in the comprehensive management of CKD.

Keywords: Calcimimetics, Calcium sensing receptors (CaSR), secondary hyperparathyroidism, Chronic kidney disease, cinacalcet, clinical efficacy, therapeutic outcomes.