Management of secondary hyperparathyroidism: The gap between diagnosis andtreatment

In mild secondary hyperparathyroidism, small daily doses of oral calcitriol represent the physiological form of replacement of this hormone, but in mo derate or severe cases, higher doses of calcitriol are needed to suppress p arathyroid gland overactivity. Unfortunately, in chronic renal failure, the se 2 different forms of calcitriol prescription are not always adequately s elected. This review will focus on the current use of calcitriol in renal f ailure. It includes data from a recent multicenter trial carried out in Spa in in which data was gathered from dialysis patients. This trial was design ed to determine the current approach to the prevention, diagnosis, and trea tment of renal osteodystrophy, with a special emphasis on the gap found bet ween diagnosis and treatment of secondary hyperparathyroidism. Our main goa l should be to achieve an adequate and early management of secondary hyperp arathyroidism to decrease the number of patients suffering from irreversibl e enlargement of the parathyroid glands.