Osteologie 2008; 17(03): 159-164
DOI: 10.1055/s-0037-1619863
Renale Osteopathie
Schattauer GmbH

Medikamentöse Therapie der renalen Osteopathie unter Berücksichtigung sozialmedizinischer Aspekte

Drug therapy of renal osteopathy regarding social medical aspects
H. J. Deuber
1   Medizinischer Dienst der Krankenversicherung in Bayern, Bamberg, Fachbereich Arzneimittel, Methoden- und Produktbewertung
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
28. Dezember 2017 (online)

Zusammenfassung

Zur Therapie des sekundären Hyperparathyreoidismus infolge einer Niereninsuffizienz und der damit verbundenen renalen Osteopathie stehen neben den Phosphatbindern Vitamin D und Vitamin D(-Metaboliten) sowie Kalzium-Rezeptor-“Sensitizer” (Cinacalcet) als Arzneimittel zur Verfügung. Abhängig davon, ob diese als apothekenpflichtige oder als verschreibungspflichtige Arzneimittel deklariert sind, müssen bei der Verordnung dieser Medikamente im Rahmen der vertragsärztlichen Versorgung der Patienten unterschiedliche Vorschriften beachtet werden. Zusätzlich muss beachtet werden, dass auch wirkstoffgleiche Arzneimittel in unterschiedlichen Indikationen zugelassen sind, was deren Verordnungsfähigkeit im Rahmen der vertragsärztlichen Versorgung je nach der jeweils zugelassenen Indikation einschränkt.

Summary

There are phosphate binders, vitamin D (metabolites), and a calcium receptor sensitizer for the drug therapy of secondary hyperparathyroidism due to renal insufficiency and therefore renal osteopathy. Depending on their legal status, i. e. distribution only by pharmacy or additional requirement of physician’s prescription, several different regulations have to be regarded before these drugs can be prescribed on account of the German social health insurance. Additionally it has to be taken into account that different drugs containing the same active substance have different legal indications of usage causing a restriction in prescribing these drugs on account of the German social health insurance depending on their labelled indication.

 
  • Literatur

  • 1 Apostolou T, Damianou L, Kotsiev V. et al. Treatment of severe hypercalcemia due to refractory hyperparathyroidism in renal transplant patients with the calcimimetic agent cinacalcet. Clinical Nephrology 2006; 65: 374-377.
  • 2 Apostolou T, Kollia K, Damianou L. et al. Hypercalcemia due to resistant hyperparathyroidism in renal transplant patients treated with the calcimimetic agent cinacalcet. Transplant Proc 2006; 38 10: 3514-3516.
  • 3 Banerjee D, Asif A, Striker L. et al. Short-term, high-dose pamidronate-induced acute tubular necrosis: the postulated mechanisms of bisphosphonate nephrotoxicity. Am J Kidney Dis 2003; 41 (05) E18.
  • 4 Boulanger H, Haymann JP, Fouqueray B. et al. Therapeutic failure of cinacalcet ina renal transplant patient presenting hyperparathyroidism with severe hypercalcaemia. Nephrol Dial Transplant 2005; 20 (12) 2865.
  • 5 Deuber HJ. “Off label use” von Osteoporose-Therapeutika. Osteologie forum 2006; 12 (03) 42-44.
  • 6 Deuber HJ. Bisphosphonate zur Behandlung der Osteoporose. Osteologie forum 2008; 14 (01) 13-17.
  • 7 Dong BJ. Cinacalcet: An oral calcimimetic agent for the management of hyperparathyroidism. Clin Ther 2005; 27 (11) 1725-1751.
  • 8 Drueke TB. Therapeutic failure of cinacalcet ina renal transplant patient. Nephrol Dial Transplant 2006; 21 (03) 824-825.
  • 9 El-Amm JM, Doshi MD, Singh A. et al. Preliminary experience with cinacalcet use in persistent secondary hyperparathyroidism after kidney transplantation. Transplantation 2007; 15 (83) 546-549.
  • 10 Hodsman AB. Fragility fractures in dialysis and ransplant patients. Is it osteoporosis and how should it be treated? Peritoneal Dial Int 2001; 21 (03) 247-255.
  • 11 Komaba H, Fukagawa M. Should clinicians follow the K/DOQI guidelines for treating hyperphosphatemia with sevelamer?. Nat Clin Pract Nephrol. 2007 e-pub 12.06.07.
  • 12 Kruse AE, Eisenberger U, Frey FJ, Mohaupt MG. The calcimimetic cinacalcet normalizes serum calcium in renal transplant patients with persistent hyperparathyroidism. Nephrology Dialysis Transplantation 2005; 20 (07) 1311-1314.
  • 13 Lazar E, Hebert K, Poma T, Stankus N. Long-term outcomes of cinacalcet and paricalcitol titration protocol for treatment of secondary hyperparathyroidism. Am J Nephrol 2007; 27 (03) 274-278.
  • 14 Leca N, Laftavi M, Gundroo A. et al. Early and severe hyperparathyroidism associated with hypercalcemia after renal transplant treated with cinacalcet. American Journal of Transplantation. 2006
  • 15 Leonard N, Brown JH. Persistent and symptomatic post-transplant hyperparathyroidism: a dramatic response to cinacalcet. Nephrol Dial Transplant 2006; 21 (06) 1736.
  • 16 Miller PD. Treatment of osteoporosis in chronic kidney disease and end-stage renal disease. Curr Osteoporosis Reports 2005; 03: 5-12.
  • 17 Miller PD. Treatment of metabolic bone disease in patients with chronic renal disease: a perspective for rheumatologists. Curr Rheumatology Reports 2005; 07: 53-60.
  • 18 Nowack R, Wachtler P. Hypophosphatemia anf hungry bone syndrome in a dialysis patient with secondary hyperparathyroidism treated with cinacalcet – proposal for an improved monitoring. Clin Lab 2006; 52 (11–12): 583-587.
  • 19 Rodd C. Bisphosphonates in dialysis and transplantation patients: efficacy and safety issues. Peritoneal Dial Int 2001; 21 (03) 256-260.
  • 20 Rosario R, Copley JB, Kronbichler K. et al. The utility of cinacalcet HCL for controlling persistent hyperparathyroidism following renal transplantation. NKF 2005 Spring Clinical Meetings Abstracts. Am J Kidney Dis 2005; 45 (04) A45 Abstract 116.
  • 21 Serra AL, Savoca R, Huber AR. et al. Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients. Nephrology Dialysis Transplantation 2007; 22 (02) 577-583 epub 27.09.2006.
  • 22 Serra AL, Schwarz AA, Wick FH. et al. Successful treatment of hypercalcemia with cinacalcet in renal transplant recipients with persistent hyperparathyroidism. Nephrology Dialysis Transplantation 2005; 20: 1315-1319.
  • 23 Shahapuni I, Monge M, Oprisiu R. et al. Drug insight: renal indications of calcimimetics. Nat Clin Pract Nephrol 2006; 02 (06) 316-325.
  • 24 Szwarc I, Argiles A, Garrigue V. et al. Cinacalcet chloride is efficient and safe in renal transplant recipients with post-transplant hyperparathyroidism. Transplantation 2006; 82 (05) 675-680.
  • 25 Torres ÜU. Cinacalcet HCl: a novel treatment for secondary hyperparathyroidism caused by chronic kidney disease. J Ren Nutr 2006; 16 (03) 253-258.
  • 26 Triponez F, Kebebew E, Dosseh D. et al. Lessthan-subtotal parathyroidectomy increases the risk of persistent/recurrent hyperparathyroidism after parathyroidectomy in tertiary hyperparathyroidism after renal transplantation. Surgery 2006; 140 (06) 990-997.
  • 27 Weisinger JR, Bellorin-Font E. Postmenopausal osteoporosis in the dialysis patient. Curr Opinion Nephrol and Hypertension 2003; 12: 381-386.
  • 28 Zisman AL, Hristova M, Ho LT, Sprague SM. Impact of ergocalciferol treatment of vitamin D deficiency on serum parathyroid hormone concentrations in chronic kidney disease. Am J Nephrol 2007; 27 (01) 35-43.
  • 29 Sozialgesetzbuch (SGB)V.
  • 30 Arzneimittelrichtlinien.
  • 31 Thomson Micromedex, 126 Bisphosphonates. Effects on the kidneys..