Impact of Weekly Teriparatide on the Bone and Mineral Metabolism in Hemodialysis Patients With Relatively Low Serum Parathyroid Hormone: A Pilot Study. Issue 2 (21st July 2019)

• Record Type: Journal Article
• Authors: Yamamoto, Junya; Nakazawa, Daigo; Nishio, Saori; Ishikawa, Yasunobu; Makita, Minoru; Kusunoki, Yoshihiro; Nagai, So; Fujieda, Yuichiro; Takahata, Masahiko; Yamada, Kanji; Yamamura, Tsuyoshi; Yotsukura, Akihiko; Saito, Masanobu; Shimazaki, Masaru; Atsumi, Tatsuya
• Is Part Of: Therapeutic apheresis and dialysis. Volume 24:Issue 2(2020)
• Page Start: 146
• Page End: 153
• Publication Date: 2019-07-21
• Subjects: Chronic kidney disease–mineral and bone disorder -- Low parathyroid hormone -- Low‐turnover bone disease -- Osteoporosis -- Teriparatide; Hemapheresis -- Periodicals; Dialysis -- Periodicals; Blood Component Removal -- Periodicals; Renal Dialysis -- Periodicals; Hémaphérèse -- Périodiques; Dialyse -- Périodiques; Sang -- Collecte et conservation -- Périodiques; 616
• DOI: 10.1111/1744-9987.12867
• Languages: English
• ISSNs: 1744-9979

Abstract

Abstract: Adynamic bone disease in HD patients is characterized by skeletal resistance to parathyroid hormone (PTH) or suppression of PTH release, leading to a downregulated bone turnover and bone fracture. Hence, we examined the efficacy of weekly teriparatide for HD patients with low PTH indicating adynamic bone disease without a history of parathyroidectomy. Fifteen HD patients with low PTH were recruited in this prospective observational study. Of them, 10 received teriparatide for 12 months and five nontreated patients were enrolled as control. Primary outcomes were defined as the changes in bone mineral density and bone turnover markers. Bone mineral density at the lumbar spine increased by 3.7% and 2.5% at 6 and 12 months, respectively, and bone formation markers increased, while bone resorption markers did not change in the teriparatide group. At 12 months after teriparatide administration, endogenous PTH was secreted followed by the recovery of low bone turnover. 40% of patients in the teriparatide group dropped out due to adverse events and the most common adverse event was transient hypotension. This study suggests that weekly teriparatide for HD patients with low PTH in the absence of parathyroidectomy accelerates bone formation and bone turnover, leading to increased trabecular bone mass and secretion of endogenous PTH.