Bisphosphonates used in hemodialysis patients and their effects on insulin-like growth factor

Abstract

Abstract: AIM: To observe the change of bone mineral density, insulin-like growth factors and other biochemical markers of bone metabolism before and after treatment with bisphosphonates in maintenance hemodialysis (MHD) patients with osteoporosis. METHODS: 45 hemodialysis patients with abnormal bone mass (osteopenia or osteoporosis),in addition to the supplement of calcium and calcitriol, using alendronate 70 mg/weeks, before and after 12 months treatment, the bone mineral density(BMD), serum insulin-like growth factor-1, procollagen typeⅠN-terminal propeptide(PINP) and C-terminal telopeptide of type I collagen(CTX) were detected,respectively,and the adverse drug reactions were recorded. RESULTS: Compared with the pre-treatment,the levels of serum IGF-1,the hip (femoral neck,greater trochanter,total hip) BMD were increased(P<0.05 or P<0.01);and the levels of serum PINP,CTX were decreased in pre-treatment(P<0.01).There is no significant different in the change of the lumbar spine BMD pre-and post-treatment(P>0.05).Mild gastrointestinal symptoms were found in individual patients. CONCLUSION: In MHD patients with osteoporosis,the treatment of bisphosphonates can reduce bone turnover and bone loss with good safety.Bisphosphonates may improve MHD osteoporotic patients' bone mass by increasing the IGF-1 which is closely related to bone formation.

Key words: Bisphosphonates, Hemodialysis, Osteoporos, Bone mineral density, Insulin-like growth factor

CLC Number:

DING Xiao-kai, CHEN Tian-xin, CHEN Bo, XUE Zeng-qi, XV Yv-lan. Bisphosphonates used in hemodialysis patients and their effects on insulin-like growth factor[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(10): 1153-1156.

References

[1] Jamal SA, Hayden JA, Beyene J. Low bone mineral density and fractures in long-term hemodialysis patients: a meta-analysis[J]. Am J Kidney Dis,2007,49(5):674-681.
[2] Ariyoshi T, Eishi K, Sakamoto I, et al.Effect of etidronic acid on arterial calcification in dialysis patients[J].Clin Drug Investig, 2006,26(4):215-222.
[3] Nitta K, Akiba T, Suzuki K, et al. Effects of cyclic intermittent etidronate therapy on coronary artery calcification in patients receiving long-term hemodialysis[J]. Am J Kidney Dis, 2004 ,44(4):680-688.
[4] Torregrosa JV, Moreno A, Mas M, et al. Usefulness of pamidronate in severe secondary hyperparathyroidism in patients undergoing hemodialysis[J]. Kidney Int Suppl, 2003,85(2):S88-90 .
[5] Trimarchi H, Lombi F, Forrester M, et al.Disodium pamidronate for treating severe hypercalcemia in a hemodialysis patient[J]. Nat Clin Pract Nephrol, 2006,2(8):459-463.
[6] Miller PD.Treatment of osteoporosis in chronic kidney disease and end-stage renal disease[J]. Curr Osteoporos Rep,2005,3(1):5-12.
[7] Wetmore, Benet LZ, Kleinstuck D, et al. Effects of short-term alendronate on bone mineral density in haemodialysis patients[J].Nephrology (Carlton). 2005 ,10(4):393-399.
[8] 石书梅,赵学智,陆烈,等.降钙素及二膦酸盐治疗血液透析患者肾性骨病的长期疗效[J].中华肾脏病杂志,2009,25(5):341-344.
[9] 郭郡浩, 姚茹冰, 赵智明,等.利塞膦酸钠胶囊治疗绝经后骨质疏松症疗效的影响因素分析[J]. 中国临床药理学与治疗学,2009,14(7):818-822.
[10] 林佳苗,钱冬女,夏哲林.二膦酸盐类药物的临床应用[J].医药导报,2010,29(12):1599-1602.
[11] 孙锋,丁晓洁,王超.藻蓝蛋白对大鼠脑缺血再灌注后胰岛素样生长因子及其受体的影响[J].医药导报,2010,29(11):1418-1421.
[12] Cornish J, Grey A, Callon KE, et al. Shared pathways of osteoblast mitogenesis induced by amylin,adrenomedullin,and IGF-1.Biochem Biophy[J]. Biochem Biophys Res Commun,2004,318(1):240-246.
[13] Fall C, Hindmarsh PD. Programming of growth hormone secretion and bone mineral density in elderly men: a hypothesis[J].Clin Endocrinol Metab,2001,83(2):135-139.
[14] Wezeman FH, Emanuele MA, Moskal SF, et al.Alendronate administration and skeletal response during chronic alcohol intake in the adolescent male rat[J].Bone Miner Res,2000 ,15(10):2033-2041.
[15] Noguera A,Ros JB, Pavia C, et al.Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children[J].J Pediatr Endocrinol, 2003,16(4):529-536.
[16] Antoniazzi F, Zamboni G,Lauriola S,et al. Early bisphosphonate treatment in infants with severe osteogenesis imperfecta[J].J Pediatr, 2006,149(2):174-179.
[17] Perifanis V, Vyzantiadis T, Tziomalos K, et al. Effect of zoledronic acid on markers of bone turnover and mineral density in osteoporotic patients with beta-thalassaemia[J].Ann Hematol, 2007,86(1):23-30.