| [ Summary ] |
Hemodialysis patients have a much higher frequency of fractures than healthy individuals. Some fracture cases may be related to osteoporosis. Based on "The Guideline of Prevention and Treatment of Osteoporosis, 2011", we studied the influence of intravenous alendronate sodium hydrate (ASH) administration on bone metabolism in 23 patients whose CKD-MBD markers were under control and whose serum osteoclast specific tartrate-resistant acid phosphatase type 5b fraction (TRACP-5b) was over the reference value. The average levels of TRACP-5b before administration of ASH was 873.2±80.2 mU/dl and significantly decreased to 540.4±77.3 mU/dl at 12 months. The change ratio after one year was -- 36.4±10.3 % (p<0.05). We studied the relationship between changes in bone metabolism markers and other factors involved in fractures in order to confirm of the effect of ASH. Analysis showed a significant difference between patients who were on dialysis for over 15 years versus those under 15 years (p<0.05). Our studies revealed the beneficial effects of 12-month ASH administration on bone metabolism with no significant adverse events. From the view point of preventing fractures, ASH administration should be considered in the early stages of hemodialysis. Nevertheless, ASH is excreted through the kidneys, so considering the problems with side effects due to over exposure to ASH, the dosage and dosing periods for ASH should be studied. |