H TAKAMI1, K WASHIO2, T SHIMIZU2, H GOTO3
1Saitama Honoka Clinic, Futtono Minuma Saitama, Japan, 2Saiyuu Kawaguchi Clinic, Totsukahigashi Kawaguchi, Japan, 3Saiyuu Souka Hospital, Matsubara Souka, Japan
Aim: Although denosumab increased bone mineral density (BMD) in men without renal failure, effects in hemodialysis male patients are not well known. The efficacy of denosumab for male hemodialysis patients was evaluated.
Background: Bone fractures are relatively common among hemodialysis patients and pose a significant health burden. Some studies suggested that bone mineral density was lower in patients with chronic kidney disease who had fractures.
Methods: This was an observational retrospective case-control study.
Thirty two male hemodialysis patients with low BMD (<70% of the young adult mean) were enrolled. Sixteen patients were treated with denosumab 60 mg every six months (denosumab group) (mean age 71.3 years), and another sixteen patients (control group) (mean age 67.2 years) were not treated with denosumab. BMD at the distal third of the radius was measured by X-ray absorptiometry.
Results: BMD was 57.5 ± 6.6 % of young adult mean in the denosumab group, 52.9 ± 9.5 % of young adult mean in the control group at baseline. The administration of the drug was clinically well tolerated. Episodes of hypocalcemia associated with PTH increase were seen, but easily overcome by increase carbonate calcium, calcitriol or alfacalcidol.
At one year, BMD increased 3.0 ± 3.8 % in denosumab group, decreased 4.4 ± 6.5 % in control group (P<0.001). At two year, BMD increased 2.7 ± 4.9 % in the denosumab group, decreased 6.6 ± 7.2 % in the control group (P<0.001).
Conclusion: In this observational study, denosumab therapy represents an effective treatment for male hemodialysis patients with low BMD.
1985 Tokyo Medical and Dental University M.D.
1990 Tokyo Medical and Dental University Ph. D
1992 to 1995 National Institutes of Health, Maryland USA
1996 to 1998 Tokyo metropolitan Fucyu Hospital
1998 to 2000 Saiyuu Clinic, Saitama
2000 to 2017 Saiyuu Kawaguchi Clinic, Saitama
2017 Saitama Honoka Clinic, Saitama