Bisphophonates in CKD Patients with Low Bone Mineral Density

Liu, Wen-Chih; Yen, Jen-Fen; Lang, Cheng-Lin; Yan, Ming-Tso; Lu, Kuo‐Cheng

doi:10.1155/2013/837573

Cited by 30 publications

(16 citation statements)

References 121 publications

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“…Liu et al reported that bisphosphonates should be carefully considered with specific requirements in HD patients because the use of bisphosphonates may aggravate clinical symptoms in patients with low bone turnover (BALP < 20 ng/mL and iPTH < 100 pg/mL) [19,20]. However, our study did not examine bone biopsy.…”

Section: Discussionmentioning

confidence: 83%

Clinical advantage and tolerability of ibandronate in hemodialysis patients: a retrospective study

et al. 2018

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Background: Tartrate-resistant acid phosphatase-5b (TRACP-5b) and bone-specific alkaline phosphatase (BALP) levels have not been evaluated following ibandronate treatment in hemodialysis (HD) patients. Methods: To evaluate the efficacy and tolerability of ibandronate, including TRACP-5b and BALP levels, in patients on HD, we conducted a 6-month retrospective study of 13 HD patients who were administered ibandronate at Kaetsu Hospital in Japan. All enrolled patients were placed on a regimen of intravenous ibandronate at a dose of 1 mg once every 4 weeks, from August 2015 to October 2016. Baseline and end-of-study levels of TRACP-5b and BALP were determined 1 month before and 6 months after the start of ibandronate treatment. Results: TRACP-5b levels were significantly decreased from 785.3 ± 385.8 mU/dL at baseline to 638.2 ± 423.4 mU/dL at end of study (P = 0.03). Additionally, the changing levels of TRACP-5b were positively associated with baseline hip bone mineral density (BMD) (P = 0.02, r = 0.65). In contrast, BALP levels were not significantly changed. Moreover, hip BMD tended to decrease from 0.51 ± 0.10 g/cm 2 at baseline to 0.47 ± 0.11 g/cm 2 at end of study (P = 0.07). The tolerability index showed no statistical difference between baseline and end of study. Conclusion: Our results indicate that ibandronate treatment in HD patients-especially those with low BMD-might sufficiently reduce TRACP-5b levels with no long-term changes in other clinical laboratory parameters. Therefore, ibandronate might be a feasible treatment option for HD patients who develop low BMD.

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Section: Discussionmentioning

confidence: 83%

Clinical advantage and tolerability of ibandronate in hemodialysis patients: a retrospective study

et al. 2018

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“…5C). There have also been reports showing that some drugs (e.g., steroids, TZD, and PPIs) and comorbidities (e.g., SLE, RA, DM or CKD) are associated with the occurrence of insufficiency fractures [10][11][12]. These factors are also considered to be involved in the development of AFF.…”

Section: Discussionmentioning

confidence: 99%

Study of Atypical Femoral Fracture Cases Coupled in a Multicenter Study

Zenke

Ikeda

Fukuda³

et al. 2016

J UOEH

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: There are several causes of atypical femoral fractures (AFF) in elderly Japanese patients, including longterm bisphosphonate (BP) use or bowed femoral shaft stress fractures, but the available sample size for examining AFF etiology in a single institution is limited. The purpose of this study was to categorize the characteristics of AFF by analyzing the data compiled on patients treated at our hospital and at affiliated institutes. This multicenter, retrospective, observational study included 34 AFF cases (bilateral AFF 10) in one male and 23 female patients (age range 30-90 years, mean age 73.0 years). Evaluation measures included the presence/absence of BP use, duration of BP use, history of other drug use, presence/absence of comorbidities, fracture site, presence/absence of femoral lateral bowing, bone biopsy parameters, and time to bone union. Nineteen patients were prescribed BP for osteoporosis (duration range 4-10 years, mean duration 6.1 years). Subtrochanteric and femoral shaft fractures were seen in 16 and 18 cases, respectively (complete fractures 22, incomplete fractures 12). Femoral lateral bowing (n = 16) occurred with femoral shaft fractures. Mean time to bone union was 9.0 months (complete fractures 11.3 months, incomplete fractures 3.7 months). AFF could be substantially caused by three factors: BP use, drugs other than BP/ comorbidity, and femoral lateral bowing. Twenty four patients were classified as having BP-related-type (n = 2), drug/comorbidity-type (n = 3), lateral bowing-type (n = 2), or mixed-type (n = 17) AFF. AFF etiology cannot be explained by a single cause; thus, a multifactorial etiology, including poor bone quality due to mutual interactions and mechanical stress, seems to be responsible for the occurrence of AFF. Level of evidence: Ⅳ diagnostic

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“…The proportion of persons with advanced stages of CKD and BP pretreatment was significantly higher in patients with AFF, suggesting a strong effect of CKD (28,29). Almost twice as many patients with AFF had an ongoing therapy with furosemide, reduced serum calcium levels, and increased parathyroid hormone levels with known effects on calcium metabolism (30,31).…”

Section: Discussionmentioning

confidence: 99%