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논문분류	춘계학술대회 초록집
제목	Denosumab for Osteoporosis Treatment in Hemodialysis Patients : A Single-Center Experience
저자	Sangeon Gwoo, Misun Kim, Dughyun Choi
출판정보	2019; 2019(1):
키워드	Denosumab \| Osteoporosis \| CKD \| ESRD \| Hemodialysis
초록	Chronic kidney disease exacerbates osteoporosis and the rate of fracture in ESRD (end-stage renal disease) patients is reported to be up to 17-fold higher than that of the general population. However, the treatment of osteoporosis in ESRD is complicated and not established due to different bone-mineral physiology from the general population. In this single center experience, we share our treatment experience of denosumab treatment in ESRD for 6 months period. We retrospectively reviewed the denosumab-treated ESRD osteoporosis patients of MH Yeonse Hospital from January 2018 to July 2018. Anti-osteoporotic drugs (estrogens, selective estrogen receptor modulators, bisphosphonates, parathyroid hormones) naïve patients who started denosumab in January 2018 were analyzed. Forty patients started denosumab and data of 37 patients who keep followed the clinic for 6 months were included in the analysis. Hypocalcemia occurred approximately 5 days after the first injection and reached the nadir in the first 10 days up to 1 month. After 4 months, serum calcium level reached to baseline levels. Serum phosphorus level decreased for the first two months and returned to baseline levels. Intact- parathyroid hormone (I-PTH) levels were 220 pg/mL at the bnaseline and increased to over 1000 pg/mL after 3 months and decreased to 600 pg/mL after 6 months. Hypocalcemia, hypophosphatemia and I-PTH elevation were observed in the denosumab-treated ESRD osteoporosis patients. No severe symptomatic hypocalcemia was reported during the treatment period and hypocalcemia reached to baseline level after 4 months. Further data including annual bone mineral density score should be discussed in the further follow up observation.
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