Mineral and bone disorders, including secondary hyperparathyroidism, are common in chronic kidney disease and contribute to increased mortality. Traditional therapy to control these disorders involves using phosphate binders and vitamin D sterols, but achieving appropriate results has proved difficult. The availability of calcimimetics has provided a new weapon in the arsenal to treat mineral and bone disorders. Initial clinical trials examined the use of cinacalcet in hemodialysis patients with secondary hyperparathyroidism and showed reductions in parathyroid hormone, calcium, phosphorus and calcium × phosphorus product. More recent clinical trials have attempted to show how these reductions aid in achieving specific K/DOQI goals. Additional studies have examined the use of cinacalcet in the treatment of mineral and bone disorders in CKD patients not yet on dialysis. This review summarizes recent literature regarding the use of calcimimetics in the treatment of CKD patients with mineral and bone disorders and the achievement of K/DOQI goals.
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