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International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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https://doi.org/10.5812/ijem.3794

Effects of Raloxifene on Bone Metabolism in Hemodialysis Patients With Type 2 Diabetes

Author(s):
Osamu SaitoOsamu Saito1,*, Takako SaitoTakako Saito1, Shinji AsakuraShinji Asakura2, Tetsu AkimotoTetsu Akimoto1, Makoto InoueMakoto Inoue1, Yasuhiro AndoYasuhiro Ando1, Shigeaki MutoShigeaki Muto1, Eiji KusanoEiji Kusano1
1Department of Nephrology, Jichi Medical University, [email protected], Japan
2Oyama Suginoki Clinic, Japan
International Journal of Endocrinology and Metabolism:Vol. 10, issue 2; 464-469
Published online:Apr 20, 2012
Article type:Research Article
Received:Dec 13, 2011
Accepted:Feb 22, 2012
How to Cite:Saito O, Saito T, Asakura S, Akimoto T, Inoue M, et al. Effects of Raloxifene on Bone Metabolism in Hemodialysis Patients With Type 2 Diabetes. Int J Endocrinol Metab. 2012;10(2):. doi: https://doi.org/10.5812/ijem.3794

Abstract

Background:

Osteoporosis and chronic kidney disease are common conditions in older adults, and often occur concurrently. Bone disease is caused by increased bone turnover accompanying secondary hyperparathyroidism, and by factors such as bone metabolic disorder accompanying kidney disease and postmenopausal or age-related osteoporosis, even in hemodialysis patients. Raloxifene is commonly used for the treatment of postmenopausal osteoporosis in the general population, and may be a treatment option for osteoporosis in hemodialysis patients. However, the effects of raloxifene in hemodialysis patients with type 2 diabetes have not been examined in detail.

Objectives:

This study was performed to investigate the effects of raloxifene on bone turnover markers and bone density in postmenopausal women with type 2 diabetes mellitus who were undergoing hemodialysis in Japan.

Patients and Methods:

The subjects were 60 female patients on maintenance hemodialysis (non-diabetic, n=30; diabetic, n=30). Raloxifene hydrochloride (60 mg) was administered to 14 diabetic patients and 14 non-diabetic patients for one year, and these patients were compared with control groups (no raloxifene) of 16 diabetic patients and 16 non-diabetic patients. Serum levels of N-terminal cross-linking telopeptide of type I collagen (NTx), bone alkaline phosphatase, and intact parathyroid hormone (iPTH) were measured, and bone density was determined by quantitative heel ultrasound at the speed of sound (SOS) in the calcaneus during this period.

Results:

There were no significant differences in the levels of bone turnover markers except for iPTH after treatment of diabetic and non-diabetic patients with raloxifene for one year. SOS increased after treatment with raloxifene, but was significantly decreased in the control groups. Treatment with raloxifene resulted in a significant decrease in NTx and a significant increase in SOS in both diabetic and non-diabetic patients. There were no significant differences between the diabetic and non-diabetic patients who received raloxifene.

Conclusions:

Treatment with raloxifene can suppress reduction in bone density in postmenopausal women with type 2 diabetes who are undergoing hemodialysis.

Keywords
Diabetes Mellitus
Type 2
Hemodialysis
Osteoporosis
Raloxifene

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