Objective: To investigate the prevalence of osteoporosis in patients undergoing maintenance dialysis and explore the safety and efficacy of salmon calcitonin in maintenance dialysis patients underwent with osteoporosis.
Methods: Double-energy X-ray bone density meter was used on 256 patients undergoing maintenance dialysis, 126 males and 130 females, aged 60 +/- 14 (22 -79), to measure the bone mineral density (BMD) at the lumbar spine and femoral neck. 108 of them with the T values < -2.5 s were diagnosed as with osteoporosis, and then were randomly divided into 2 equal groups matched in baseline age, sex, mode of dialysis, and levels of iPTH, ALP, and BMD: control group receiving oral administration of calcium carbonate 1500 mg tid and rocaltrol 0.25 microg qn for 18 months, and experimental group, received subcutaneous injection of salmon calcitonin (50 U) three times a week in addition. The BMD levels of lumbar spine and femoral neck, and serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) were assessed before treatment and 3, 6, 12, and 18 months after treatment.
Results: (1) The osteoporosis rate of the 256 maintenance dialysis patients was 42.19%. (2) The osteoporosis rate of the 201 patients undergoing maintenance hemodialysis (MHD) was 47.76%, significantly higher than that of the 55 patients undergoing maintenance peritoneal dialysis (21.82%, P < 0.01). (3) At the end of the trial, there was a significant increase of BMD of lumbar spine and femoral neck in the experiment group compared with the control group. (4) Compared with the control group, the serum ALP, iPTH, and BGP levels 3, 6, 12, and 18 months after treatment were all significantly lower than the baseline level and those of the corresponding control groups (all P < 0.01). The serum calcium of the control group at the end of experiment increased significantly in comparison with baseline level (P < 0.05). (5) No adverse events were found after the treatment of salmon calcitonin.
Conclusion: Salmon calcitonin effectively increases the BMD of the maintenance dialysis patients and is well tolerated.