Which medication is used as an alternative treatment for ESRD patients not responsive to vitamin D for secondary hyperparathyroidism?

Which medication is used as an alternative treatment for ESRD patients not responsive to vitamin D for secondary hyperparathyroidism?

• A. Cinacalcet
• B. Epoetin
• C. Furosemide
• D. Lisinopril

Answer: (A)

Secondary hyperparathyroidism in ESRD is often treated when vitamin D therapy isn’t effective. Cinacalcet works here because it is a calcimimetic that makes the calcium-sensing receptors on the parathyroid glands more sensitive to extracellular calcium. That increased sensitivity suppresses PTH secretion, helping lower PTH levels and improve the calcium-phosphate balance in dialysis patients. It provides an alternative mechanism to control SHPT beyond vitamin D analogs, especially when patients are not responding to vitamin D alone. The other drugs don’t target PTH in this scenario: Epoetin treats anemia of CKD, not parathyroid hormone excess; furosemide is a diuretic used for fluid management rather than correcting SHPT in ESRD; lisinopril is an ACE inhibitor for blood pressure and kidney protection, not a treatment for secondary hyperparathyroidism.

Secondary hyperparathyroidism in ESRD is often treated when vitamin D therapy isn’t effective. Cinacalcet works here because it is a calcimimetic that makes the calcium-sensing receptors on the parathyroid glands more sensitive to extracellular calcium. That increased sensitivity suppresses PTH secretion, helping lower PTH levels and improve the calcium-phosphate balance in dialysis patients. It provides an alternative mechanism to control SHPT beyond vitamin D analogs, especially when patients are not responding to vitamin D alone.

The other drugs don’t target PTH in this scenario: Epoetin treats anemia of CKD, not parathyroid hormone excess; furosemide is a diuretic used for fluid management rather than correcting SHPT in ESRD; lisinopril is an ACE inhibitor for blood pressure and kidney protection, not a treatment for secondary hyperparathyroidism.