Pamidronate Therapy for Preventing Steroid-Induced Osteoporosis in Children with NephropathyKim S.-D. · Cho B.-S.
East-West Kidney Disease Research Institute and Department of Pediatrics, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu,Seoul, Korea
Background: Steroid-induced osteoporosis (SIO) is a serious complication of long-term steroid therapy and is of particular concern in growing children. Recently bisphosphonates have been applied in the treatment or prevention of SIO. We investigated the efficacy of pamidronate on SIO in childhood nephropathy patients receiving long-term corticosteroid therapy. Methods: Forty-four children receiving high doses of steroids were enrolled in the study. There was no history of bone, liver, or endocrine disease. Patients were randomly classified into two groups, the control group and the study group. All patients received corticosteroids for 3 months. Control group took oral calcium supplements (500 mg/day) only, and the study group oral calcium and pamidronate (125 mg) for 3 months. Biochemical tests, long bone radiography, and bone mineral density (BMD) were performed in the first month and 3 months later in all patients. Results: The differences in the results of biochemical tests such as serum calcium, BUN, and cre atinine level obtained in the first month and three months later were not of statistical significance in both the control and the study groups. However, the mean BMD of the lumbar spine decreased from 0.654 ± 0.069 (g/cm2) to 0.631 ± 0.070 (g/cm2) in the control group (p = 0.0017), while it did not in the study group from 0.644 ± 0.189 (g/cm2) to 0.647 ± 0.214 (g/cm2). Conclusions: Pamidronate appears to be effective in preventing SIO in children with nephropathy requiring long-term steroid therapy. Further long-term follow-up studies regarding the efficacy and side effects appear to be necessary to set a more solid basis for such pediatric uses of bisphosphonates such as pamidronate.
© 2006 S. Karger AG, Basel
The abstract of this article was presented at the oral session of the Korean Society of Nephrology, 24th Annual Meeting.
Received: December 8, 2004
Accepted: June 7, 2005
Published online: November 10, 2005
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 3, Number of References : 37
Nephron Clinical Practice
Vol. 102, No. 3-4, Year 2006 (Cover Date: February 2006)
Journal Editor: Powis, S.H. (London)
ISSN: 1660–2110 (print), 1660–2110 (Online)
For additional information: http://www.karger.com/NEC