TREATMENT WITH PARICALCITOL: CLINICAL IMPLICATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Chronic kidney disease (CKD) is a growing public health concern, often linked to diabetes mellitus and arterial hypertension, and frequently complicated by mineral and bone metabolism disorders due to phosphorus and calcium imbalances.These contribute to cardiovascular calcifications, nephrolithiasis, and bone demineralisation.This review analyses the pharmacological profile and clinical efficacy of paricalcitol in CKD-related mineral and bone disorders.A qualitative assessment was conducted on a series of clinical trials, meta-analyses, and cohort studies, selecting English-language, peerreviewed studies involving CKD patients (stages 2-5), with or without diabetes and haemodialysis.Paricalcitol was found to reduce parathyroid hormone levels, proteinuria, and inflammatory markers, with favourable safety and tolerability profiles.Emerging evidence indicates potential cardiovascular benefits and disease-modifying effects in diabetic nephropathy, though the impact on creatinine levels and mortality outcomes remains inconclusive and warrants further research. RezumatBoala cronic de rinichi (BCR) este adesea asociat cu diabetul zaharat i hipertensiunea arterial, i complicat frecvent cu tulburri ale metabolismului mineral i osos din cauza dezechilibrelor de fosfor i calciu, acestea contribuind la calcificr ile din sistemul cardiovascular, la nefrolitiaz i la demineralizarea osoas.Acest articol analizeaz profilul farmacologic i eficacitatea clinic a paricalcitolului n tulburrile minerale i osoase asociate cu BCR.A fost realizat o evaluare calita tiv a unei serii de studii clinice, meta-analize i studii de cohort, selectnd lucrri n limba englez, care au inclus pacieni cu BCR (stadiile 2-5), cu sau fr diabet, aflai sau nu sub hemodializ.S-a constatat c paricalcitol reduce nivelurile hormonului paratiroidian, proteinuria i markerii inflamatorii, avnd profile favorabile de siguran i tolerabilitate.Dovezile emerge nte indic posibile beneficii cardiovasculare i efecte modificatoare ale bolii n nefropatia diabetic, dei impactul asupra nivelurilor de creatinin i a rezultatelor mortalitii rmne neconcludent i necesit cercetri suplimentare .