2015
DOI: 10.1159/000380960
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Hypocalcemia Post Denosumab in Patients with Chronic Kidney Disease Stage 4-5

Abstract: Background: Denosumab, a RANK-ligand inhibitor, is an effective treatment for osteoporosis in postmenopausal women and men. Unlike the bisphosphonates, it is not excreted by the kidney. Little is known, however, about its efficacy and safety in patients with severe chronic kidney disease (CKD). Methods: A retrospective study was performed in CKD 4-5D patients from a tertiary referral hospital who were treated with denosumab between 1st January 2011 and 31st March 2014. Data collected included information about… Show more

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Cited by 113 publications
(88 citation statements)
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“…However, it may occur frequently in patients with a stage 4-5 chronic kidney disease, where the use of BPs is formally contraindicated [73]. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) is highly recommended in patients with severe renal insufficiency (CHK stage 5).…”
Section: Denosumabmentioning
confidence: 99%
“…However, it may occur frequently in patients with a stage 4-5 chronic kidney disease, where the use of BPs is formally contraindicated [73]. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) is highly recommended in patients with severe renal insufficiency (CHK stage 5).…”
Section: Denosumabmentioning
confidence: 99%
“…Post-denosumab hypocalcemia occurred in 5.2% of the cancer patients (1), but such an event was rarely reported in osteoporosis patients (2). Recently, severe hypocalcemia because of a lower dose of denosumab for osteoporosis has been reported in chronic kidney disease (CKD) patients (3,4). We describe the first case of rheumatoid arthritis (RA) and CKD associated with severe hypocalcemia and prolonged QT interval after the administration of a lower dose of denosumab.…”
mentioning
confidence: 99%
“…Yet several cases of hypocalcaemia in patients receiving denosumab in the setting of renal disease have been reported 1 9 12. Denosumab blocks PTH-dependent osteoclastic activity, which is one of the main driving mechanisms for maintaining calcium homeostasis in kidney disease 9. Moreover, patients with impaired renal function have potential vitamin D deficiency due to reduced 1-alpha hydroxylase activity, which increases the risk of hypocalcaemia further 13.…”
Section: Discussionmentioning
confidence: 99%