Can calcimimetics inhibit nodular hyperplasia of parathyroid glands?
Email: fukagawa{at}med.kobe-u.ac.jp’ + u + ‘@’ + d + ”//–> Sir, In a recent editorial review, Drueke and associates [1] summarized the pre-clinical data on the pathogenesis of parathyroid hyperplasia in chronic kidney disease (CKD) and its possible prevention and treatment by calcimimetics. Although intensively discussed, the authors have left an important clinical issue unsolved, i.e. whether calcimimetics can effectively control parathyroid hyperfunction in patients with nodular hyperplasia, the advanced type of parathyroid hyperplasia. As they noted, nodular hyperplasia cannot be replicated in model animals of CKD even with the most severe hyperparathyroidism. It has been well recognized that cells in nodular hyperplasia have reduced numbers of vitamin D receptor (VDR) and calcium-sensing receptor (CaSR), thus usually refractory to medical therapies [2]. Development of nodular hyperplasia has been most efficiently diagnosed by the size of the enlarged glands evaluated by ultrasono
