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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ishani, Areef Blackwell, Terri Jamal, Sophie A. Cummings, Steven R. Ensrud, Kristine E. |
| Description | Country affiliation: United States Author Affiliation: Ishani A ( Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, and Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55417, USA. isha0012@umn.edu) |
| Abstract | It is unknown whether treatment for osteoporosis with raloxifene is safe or effective in those with chronic kidney disease (CKD). With data from a multicenter, randomized, placebo-controlled trial of 7705 postmenopausal women with osteoporosis, the effect of raloxifene on rate of change of bone mineral density (BMD), incidence of fractures, and adverse events by stage of CKD was examined over 3 yr. Baseline serum creatinine values were available for 7316 women, and these values were used to assign a category of creatinine clearance (CrCl) using the Cockcroft-Gault formula (CrCl < 45, 45 to 59, and > or = 60 ml/min). BMD was measured at baseline and annually by dual x-ray absorptiometry. Within the placebo group, lower baseline CrCl was associated with a trend for higher annual losses of BMD at the femoral neck; however, within the raloxifene group, lower baseline CrCl was associated with greater increases in femoral neck BMD. This interaction between category of CrCl and treatment assignment was significant for rate of change of BMD at the hip. Irrespective of kidney function, raloxifene treatment was associated with a greater increase in spine BMD, a reduction in vertebral fractures, and no effect on nonvertebral fractures compared with placebo. Within each category of kidney function, adverse events were similar between the raloxifene and placebo groups. In conclusion, raloxifene increases BMD at both the hip and the spine and reduces the risk for vertebral fractures among individuals with CKD. The effect ofraloxifene on hip BMD is greater among those with mild to moderate CKD. |
| File Format | HTM / HTML |
| ISSN | 10466673 |
| e-ISSN | 15333450 |
| DOI | 10.1681/ASN.2007050555 |
| Journal | Journal of the American Society of Nephrology |
| Issue Number | 7 |
| Volume Number | 19 |
| Language | English |
| Publisher | American Society of Nephrology |
| Publisher Date | 2008-07-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline Nephrology Bone Density Conservation Agents Therapeutic Use Kidney Failure, Chronic Complications Osteoporosis, Postmenopausal Drug Therapy Raloxifene Bone Density Drug Effects Adverse Effects Spinal Fractures Etiology Prevention & Control Multicenter Study Randomized Controlled Trial |
| Content Type | Text |
| Resource Type | Article |
| Subject | Nephrology |
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