Risedronate therapy for the prevention of steroid-induced osteoporosis in patients with minimal-change nephrotic syndrome

Takashi Takei, Mitsuyo Itabashi, Misao Tsukada, Hidekazu Sugiura, Takahito Moriyama, Chiari Kojima, Shunji Shiohira, Ari Shimizu, Kazunori Karasawa, Nobuyuki Amemiya, Kunio Kawanishi, Tetsuya Ogawa, Keiko Uchida, Ken Tsuchiya, Kosaku Nitta

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background Minimal-change nephrotic syndrome (MCNS) is treated by the administration of prednisolone (PSL) at high doses. Steroid-induced osteoporosis is a serious adverse effect of this drug. Methods Patients with MCNS were randomly assigned to two groups, the risedronate (2.5 mg/day) + alfacalcidol (0.25 μg/day) group (n=20) and the alfacalcidol (0.25 μg/day)-alone group (n=20). All the patients had received PSL and the clinical characteristics were compared between the two groups at baseline and at 12 months. Results A significant decrease of the mean bone mineral density (BMD) of the lumbar spine from 0.710± 0.162 (g/cm2) to 0.588±0.125 was observed in the alfacalcidol-alone group (p=0.02), while no such decrease of the bone mineral density was found in the risedronate + alfacalcidol group (0.663±0.169 at baseline and 0.626±0.129 at 12 months). No significant differences in the results of other biochemical tests performed at the baseline and at 12 months were observed between the two groups. The likelihood of development of steroid-induced osteoporosis was influenced by the cumulative dose of PSL, the mean BMD at the baseline, occurrence of disease relapse, and risedronate therapy. Conclusion Risedronate appears to be effective in preventing steroid-induced osteoporosis. It is necessary to use bisphosphonates to maintain the BMD in patients with MCNS receiving prolonged steroid therapy.

Original languageEnglish (US)
Pages (from-to)2065-2070
Number of pages6
JournalInternal Medicine
Volume49
Issue number19
DOIs
StatePublished - Oct 26 2010

Keywords

  • Bone mineral density
  • Minimal change nephritic syndrome
  • Risedronate
  • Steroid-induced osteoporosis

ASJC Scopus subject areas

  • Internal Medicine

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    Takei, T., Itabashi, M., Tsukada, M., Sugiura, H., Moriyama, T., Kojima, C., Shiohira, S., Shimizu, A., Karasawa, K., Amemiya, N., Kawanishi, K., Ogawa, T., Uchida, K., Tsuchiya, K., & Nitta, K. (2010). Risedronate therapy for the prevention of steroid-induced osteoporosis in patients with minimal-change nephrotic syndrome. Internal Medicine, 49(19), 2065-2070. https://doi.org/10.2169/internalmedicine.49.3707