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Erschienen in: Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen 2/2020

07.02.2020 | Originalien

Moderne Behandlungsoptionen des sekundären Hyperparathyreoidismus vor dem Hintergrund kardiovaskulärer Kalzifizierung

verfasst von: OA PD Dr. Emanuel Zitt

Erschienen in: Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen | Ausgabe 2/2020

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Zusammenfassung

Der sekundäre Hyperparathyreoidismus (sHPT) hat unbehandelt deletäre Auswirkungen auf verschiedene Organsysteme. Insbesondere die kardiovaskuläre Kalzifizierung als Folge der mit dem sHPT einhergehenden Veränderungen des Knochen- und Mineralstoffwechsels und der zu dessen Therapie eingesetzten medikamentösen Interventionen ist in den Mittelpunkt der Forschung und Behandlungskonzepte gerückt. Sämtliche eingesetzten Therapien sind effektiv im Hinblick auf eine Korrektur der laborchemisch fassbaren Veränderungen im Rahmen des sHPT, aber nur sehr wenige auch klinisch in ihrer Auswirkung auf die kardiovaskuläre Kalzifizierung und patientenbezogene Endpunktdaten (Mortalität, kardiovaskuläre Morbidität) in aussagekräftigen Studien untersucht. Die geringe Anzahl qualitativ hochwertiger randomisierter kontrollierter Studien darf nicht zu einem nihilistischen Ansatz führen. Aufgrund unzureichender Daten ist keine der Therapieoptionen (Phosphatbinder, Substitution mit nativem Vitamin D oder Calcitriol und Analoga, Kalzimimetikum, Parathyreoidektomie) prinzipiell den anderen überlegen, wenn auch patienten- und situationsbezogen Vorteile für die eine oder andere Therapie bestehen. Ein breiteres therapeutisches Fenster verlangt oft eine Kombination dieser Behandlungsoptionen und eine Individualisierung der sHPT-Therapie.
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Metadaten
Titel
Moderne Behandlungsoptionen des sekundären Hyperparathyreoidismus vor dem Hintergrund kardiovaskulärer Kalzifizierung
verfasst von
OA PD Dr. Emanuel Zitt
Publikationsdatum
07.02.2020
Verlag
Springer Vienna
Erschienen in
Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen / Ausgabe 2/2020
Print ISSN: 2412-8260
Elektronische ISSN: 2412-8287
DOI
https://doi.org/10.1007/s41970-020-00098-7

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