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

AUTHORS

Osamu Saito 1 , * , Takako Saito 1 , Shinji Asakura 2 , Tetsu Akimoto 1 , Makoto Inoue 1 , Yasuhiro Ando 1 , Shigeaki Muto 1 , Eiji Kusano 1

AUTHORS INFORMATION

1 Department of Nephrology, Jichi Medical University, nephsait@jichi.ac.jp, Japan

2 Oyama Suginoki Clinic, Japan

ARTICLE INFORMATION

International Journal of Endocrinology and Metabolism: 10 (2); 464-469
Published Online: April 20, 2012
Article Type: Original Article
Received: December 13, 2011
Accepted: February 22, 2012
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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

© 2012, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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