The effect of raloxifene treatment in postmenopausal women with CKD

Areef Ishani, Terri Blackwell, Sophie A. Jamal, Steven R. Cummings, Kristine E. Ensrud

Research output: Contribution to journalArticlepeer-review

104 Scopus citations

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 (CrCI) using the Cockcroft-Gault formula (CrCI <45, 45 to 59, and ≥60 ml/min). BMD was measured at baseline and annually by dual x-ray absorptiometry. Within the placebo group, lower baseline CrCI was associated with a trend for higher annual losses of BMD at the femoral neck; however, within the raloxifene group, lower baseline CrCI was associated with greater increases in femoral neck BMD. This interaction between category of CrCI 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 of raloxifene on hip BMD is greater among those with mild to moderate CKD.

Original languageEnglish (US)
Pages (from-to)1430-1438
Number of pages9
JournalJournal of the American Society of Nephrology
Volume19
Issue number7
DOIs
StatePublished - Jul 2008

Bibliographical note

Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.

Fingerprint Dive into the research topics of 'The effect of raloxifene treatment in postmenopausal women with CKD'. Together they form a unique fingerprint.

Cite this