Efficacy and safety of medications for osteoporosis in kidney transplant recipients or patients with chronic kidney disease: A meta-analysis

作者全名："Leng, Yunji; Yu, Xian; Yang, Yi; Xia, Yifan"

作者地址："[Leng, Yunji; Yu, Xian; Yang, Yi] Chongqing Med Univ, Affiliated Hosp 2, Phase Clin Trial Ctr 1, Chongqing, Peoples R China; [Xia, Yifan] Chongqing Gen Hosp, Dept Joint Surg, 118 Xingguang Ave, Chongqing 401121, Peoples R China"

通信作者："Xia, YF (通讯作者)，Chongqing Gen Hosp, Dept Joint Surg, 118 Xingguang Ave, Chongqing 401121, Peoples R China."

来源：JOURNAL OF INVESTIGATIVE MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001092507900009

JCR分区：Q2

影响因子：2.6

年份：2023

卷号：71

期号：7

开始页：760

结束页：772

文献类型：Review

关键词：Osteoporosis; bisphosphonates; raloxifene; denosumab; teriparatide; chronic kidney disease

摘要："This study conducted a meta-analysis to analyze the efficacy and safety of osteoporosis medications in kidney transplant recipients and patients with chronic kidney disease (CKD). PubMed, Embase, the Cochrane Central Register of Controlled Trials were searched from the date of their inception through October 21, 2022. We performed a meta-analysis of the efficacy and safety of osteoporosis medications in adult patients with stage 3-5 CKD or kidney transplant recipients enrolled in randomized clinical trials (RCTs). We calculated the standard mean deviations with 95% confidence intervals (CI) for bone mineral density (BMD) and T scores after 6 and 12 months treatment, pooled odds ratio and 95% CI for fracture risk, and summarized adverse events. The inclusion criteria were met by 27 studies. Out of this, 19 studies were included for the meta-analysis. In stage 3-4 CKD patients, alendronate increased lumbar spine BMD. In patients at stage 5 CKD and undergoing hemodialysis, alendronate and raloxifene increased lumbar spine BMD. After 6 months, the BMD of kidney transplant recipients was seen to be significantly increased; however, there was no difference after 12 months, and the risk of fracture did not reduce. Thus, there is no evidence that these medications reduce the risk of fracture, and their effect on BMD and fracture remains unproven. These medications may increase the incidence of adverse events and their safety needs to be further evaluated. Therefore, we cannot draw a definitive conclusion about the efficacy and safety of osteoporosis medications in the above group of patients."

基金机构：National Natural Science Foundation of China [82072327]; Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University

基金资助正文："The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Natural Science Foundation of China (grant numbers 82072327) and Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University."