Effect of Raloxifene on Parathyroid Hormone in Osteopenic and Osteoporotic Postmenopausal Women With Chronic Kidney Disease Stage 5

Abstract

Introduction. This study was aimed to investigate the effects of raloxifene on intact parathyroid hormone (PTH) level and bone mineral density (BMD) for 8 months in women on hemodialysis and women with chronic kidney disease stage 5 not dependent on dialysis to determine its effect on secondary hyperparathyroidism and osteoporosis.

Materials and Methods. Fifty-one women on hemodialysis and 9 with chronic kidney disease stage 5 were randomly assigned to receive oral raloxifene, 60 mg/d, or placebo for 8 months. Baseline blood determinations and BMD were done and repeated after 8 months. Serum levels of total calcium, phosphorus, alkaline phosphatase, and intact PTH were measured.

Results. Serum levels of intact PTH significantly decreased in both groups, and there was no difference between the two groups after 8 months (P = .37). Serum phosphorus levels also decreased by 1.8% in the two groups. After 8 months of treatment, the BMD of the lumbar spine and femural neck decreased by 1.9% in the control group, while an increase in BMD was observed in the raloxifene group,with an average increase in both BMDs of the lumbar spine and the femural neck by 2% (significant in the lumbar spine; P = .01).

Conclusions.   Raloxifene has proven to be an effective medication in terms of improving BMD, with no adverse effects. However, it had no effect on controlling hyperparathyroidism in our patients. Long-term studies should be done to investigate the effects of raloxifene in chronic kidney disease and dialysis patients.