Update on the Calcium-Sensing Receptor

Abstract

The cells of the human body have a receptor that is sensitive to extracellular calcium [calcium-sensing receptor (CaSR)] and whose tissue expression is decreased in patients with chronic kidney disease. The CaSR plays a key role both in the regulation of PTH secretion by parathyroid cells, as well as in calcium tubular reabsorption by renal tubular cells. Recent biochemical and cellular studies found that this receptor has peculiar functional characteristics. Furthermore, pharmacological research has brought to the marker agonists for CaSR (calcimimetics) that today are used for treating secondary hyperparathyroidism and may have an effect on cardiovascular and bone diseases in patients with chronic kidney disease. With regard to the latter, the EVOLVE and ADVANCE trials were dedicated to understanding the role of cinacalcet, a calcimimetic drug, in the prevention of vascular calcification and cardiovascular events in patients with chronic kidney disease. Research in this field has thus opened promising perspectives for the treatment of chronic kidney disease.