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논문분류	춘계학술대회 초록집
제목	Trends in serum phosphate, calcium, and parathyroid hormone levels with denosumab treatment according to renal function
저자	Jin Hyeog Lee
출판정보	2023; 2023(1):
키워드
초록	Objectives: Osteoporosis and chronic kidney disease (CKD) are major risk factors for fracture. Denosumab is widely used for treating osteopenia in patients with CKD. However, the changes in phosphate, calcium, and parathyroid hormone (PTH) levels after denosumab treatment in patients with CKD have not been extensively elucidated. Methods: A retrospective observational study performed in patients from three hospitals in Korea who were treated with denosumab between November 2016 and December 2021. Data were collected from medical record. We compared the mean percentage change in serum phosphate, calcium, and PTH levels from baseline to 6 months after denosumab injection according to patients’ kidney function. Results: Among the 11,586 patients (median age, 70.0 years; 89.2% female), 10,069 (87.9%) patients whose estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m2 defined preserved kidney function group and eGFR under 60 mL/min/1.73m2 defined reduced kidney function group. 8,050 (74.9%) patients received supplemental calcium/vitamin D prior to denosumab injection. Serum calcium (-3.18% in preserved kidney function group and -6.35% in reduced kidney function group) and phosphate levels (-10.9% and -9.56%, respectively) decreased, and serum PTH levels (+123.54% and +216.93%, respectively) were increased 1 month after denosumab administration. But the three serum parameters returned to their baseline values 6 months after injection in both groups. [주1][이2]However, a higher rate of hypocalcemia 6 months after denosumab injection was observed in reduced kidney function group than preserved kidney function group (4.5% and 8.3%, respectively, p-value<0.001). Conclusions: At one month after denosumab treatment, serum levels of phosphate and calcium significantly decreased, and PTH levels were increased; however, these trends were transient. When using denosumab with reduced kidney function patients, close monitoring and replacement of calcium and calcitriol is required. Otherwise, denosumab might be a safe treatment option.
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