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Improving Management of Secondary Hyperparathyroidism (SHPT) in Non-Dialysis Patients

Improving Management of Secondary Hyperparathyroidism (SHPT) in Non-Dialysis Patients

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Improving Management of Secondary Hyperparathyroidism (SHPT) in Non-Dialysis Patients

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Presentation Transcript

  1. Improving Management of Secondary Hyperparathyroidism (SHPT) in Non-Dialysis Patients

  2. CKD Is a Global Burden With Major Implications

  3. CKD-MBD

  4. Pathophysiology of CKD-MBD

  5. Biochemical Phenotype of Disordered Mineral Metabolism in CKD

  6. SHPT Is a Component of CKD-MBD Pathophysiology

  7. Bone-Kidney-Parathyroid Endocrinological Feedback Loop

  8. Vitamin D Metabolism: 1,25(OH)2 D Levels Are Tightly Regulated

  9. Low Levels Of 25(OH)D (Calcifediol) Increase the Risk of Disease Progression and Mortality in Patients With CKD

  10. Relationship Between 25(OH)D and PTH in CKD

  11. Vitamin D Nomenclature

  12. Relationship Between 25(OH)D and PTH Before and After Treatment With Vitamin D and Calcium for 8 Weeks

  13. 2017 Revised KDIGO Guidelines PTH -- Vitamin D

  14. 2017 Revised KDIGO Guidelines PTH -- Vitamin D (cont)

  15. Management of Bone Mineral Parameters Remains the Therapeutic Goal

  16. Management of PTH and Vitamin D

  17. Ergocalciferol Treatment in Stage 3 and 4 CKD

  18. Improved PTH With Calcitriol in CKD Stages 3 and 4

  19. Oral Paricalcitol in Treatment of SHPT in CKD 3 & 4

  20. Paricalcitol vs Calcitriol in CKD-MBD

  21. Vitamin D Receptor Activators Did Not Improve CV Outcomes but Increased Hypercalcemia Risk

  22. Ergocalciferol vs Paricalcitol for SHPT in CKD Stages 3 and 4

  23. Calcifediol ER Increases 25(OH)D Levels And Reduces iPTH in Patients With Non-Dialysis CKD

  24. Calcifediol ER Increased Serum Total 25-Hydroxyvitamin D: 1-Year Results

  25. Calcifediol ER Lowers Plasma PTH Consistently Over Time

  26. Calcifediol ER Has an Inconsequential Impact on Serum Calcium and Phosphorus

  27. Comparison of Vitamin D Therapies for Stage 3-4 CKD

  28. Summary and Conclusions

  29. Abbreviations

  30. Abbreviations (cont)