Effects of raloxifene on bone metabolism in postmenopausal women on chronic hemodialysis

Nagatoya, Katsuyuki; Nishimoto, Kazuhiko; Shibahara, Nobuhisa; Takahashi, Tomohiro; Kanehara, H; Ueno, Nobuyuki; Yasuda, Hideaki; Okada, Shigeki; Ueda, Haruhiko; Hirai, Kei; Inoue, Toru

doi:10.1007/s10157-014-1065-z

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…Although teriparatide is, indeed, effective in some dialysis patients, its vasodilative action often compels a discontinuation of the treatment because it can induce severe hypotension. Regarding the clinical effect of selective estrogen receptor modulators in CKD patients, no clear consensus has been established [60]. …”

Section: Fragility Fracture Prevention In Ckd Patientsmentioning

confidence: 99%

Chronic kidney disease and fragility fracture

Kazama

2016

Clin Exp Nephrol

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Osteoporosis is defined simply as “a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Thus, any bone lesion that causes fragility fracture is osteoporosis, which has quite heterogeneous backgrounds. Chronic kidney disease-related bone and mineral disease (CKD-MBD) is defined as “a systemic disorder of mineral and bone metabolism due to CKD, which is manifested by abnormalities in bone and mineral metabolism and/or extra-skeletal calcification”. Although CKD-MBD is one of the possible causes of osteoporosis, we do not have evidences that CKD-MBD is the only or crucial determinant of bone mechanical strength in CKD patients. The risk of hip fracture is considerably high in CKD patients. Drugs that intervene in systemic mineral metabolism, indeed, lead to the improvement on bone histology in CKD patients. However, it remains unclear whether the intervention in systemic mineral metabolism also improves bone strength, today. Thus, the use of drugs that directly act on bone and the introduction of fracture liaison concept are promising strategies for fragility fracture prevention among CKD patients, as well as treatment for CKD-MBD.

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Section: Fragility Fracture Prevention In Ckd Patientsmentioning

confidence: 99%

Chronic kidney disease and fragility fracture

Kazama

2016

Clin Exp Nephrol

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“…CKD-associated osteoporosis is more prominent in postmenopausal uremic patients, highlighting the potential role of estrogen in the disease process [298,299]. For instance, raloxifene was effective in improving bone mineral density (BMD) in postmenopausal osteoporotic women with CKD [300][301][302][303]. Further studies revealed that ERa gene polymorphism might dictate the different outcomes of BMD in postmenopausal hemodialysis patients who received raloxifene [304].…”

Section: Chronic Kidney Disease-mineral and Bone Disorder (Ckd-mbd)mentioning

confidence: 99%

Estrogen and estrogen receptors in kidney diseases

Chen

2021

Renal Failure

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Acute kidney injury (AKI) and chronic kidney disease (CKD) are posing great threats to global health within this century. Studies have suggested that estrogen and estrogen receptors (ERs) play important roles in many physiological processes in the kidney. For instance, they are crucial in maintaining mitochondrial homeostasis and modulating endothelin-1 (ET-1) system in the kidney. Estrogen takes part in the kidney repair and regeneration via its receptors. Estrogen also participates in the regulation of phosphorus homeostasis via its receptors in the proximal tubule. The ERa polymorphisms have been associated with the susceptibilities and outcomes of several renal diseases. As a consequence, the altered or dysregulated estrogen/ERs signaling pathways may contribute to a variety of kidney diseases, including various causes-induced AKI, diabetic kidney disease (DKD), lupus nephritis (LN), IgA nephropathy (IgAN), CKD complications, etc. Experimental and clinical studies have shown that targeting estrogen/ERs signaling pathways might have protective effects against certain renal disorders. However, many unsolved problems still exist in knowledge regarding the roles of estrogen and ERs in distinct kidney diseases. Further research is needed to shed light on this area and to enable the discovery of pathwayspecific therapies for kidney diseases.

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“…After discarding the duplicate studies and screening, 10 studies were selected for full-text examination. One study was excluded because there was no placebo/control group [33]. One study was excluded because patients had normal baseline kidney functions [34].…”

Section: Study Selectionmentioning

confidence: 99%

Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

Chen

et al. 2021

Horm Metab Res

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As a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

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Effects of raloxifene on bone metabolism in postmenopausal women on chronic hemodialysis

Cited by 8 publications

References 21 publications

Chronic kidney disease and fragility fracture

Chronic kidney disease and fragility fracture

Estrogen and estrogen receptors in kidney diseases

Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

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