Abstract: SA-PO261
Serial Change of Serum Calcium and Management of Hypocalcemia After Denosumab Treatment in Hemodialysis Patients: A Single-Center Experience
Session Information
- Bone and Mineral Metabolism: Calcium, Magnesium, Kidney Stones
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Ahn, Jeongmyung, Division of Nephrology, Internal Medicine, Busan, Korea (the Republic of)
- Lee, Heeryong, Division of Nephrology, Internal Medicine, Busan, Korea (the Republic of)
- Lee, Dong Ryeol, Division of Nephrology, Internal Medicine, Busan, Korea (the Republic of)
- Jeon, Mi young, Maryknoll Medical Center, Busan, Korea (the Republic of)
Background
Denosumab is a new drug of osteoporosis. It inhibits osteoclast formation and decreases bone resorption. Most common side effect is hypocalcemia. A prevalence of hypocalcemia after use of denosumab in HD patients is not clear.
Methods
We treated osteoporosis in HD patients with denosumab 60mg s.c.. To prevent hypocalcemia, we gave Dicamax(cholecalciferol 1000 IU and calcium carbonate 1250mg) during a week before use of denosumab. After treatment, we checked serial serum calcium, every visit, during 2 weeks. When below 8mg/dL of serum calcium, patients was administrated with intravenous calcium gluconate(2g/20ml) according to our policy. We evaluated a serial change of serum calcium and prevalence of hypocalcemia after treatment. Also, We checked a percentage of patients who were replaced intravenous calcium.
Results
Total number of patients treated with denosumab was 53(female 43, 81.1%). Median age was 69 years old(45~83 years old). Median vintage of hemodialysis was 4.2 months(0.2~113.6months). Of 53 patients, there were 35(66%) diabetes and 19(35.8%) fractures. Basal calcium, phosphorus and iPTH were 9.1±0.53mg/dL, 4.1±1.34mg/dL, and 229.8±171.7pg/dL. Serial mean serum calcium was 8.4±0.80mg/dL, 8.8±0.82mg/dL, 8.9±1.14mg/dL, 8.6±1.11mg/dL, 8.9±1.03mg/dL, 9.1±1.13mg/dL and 9.2±1.01mg/dL, on the first day of 1st and 2nd week, 1st, 2nd, 3rd, 4st and 5st month later. Nadir calcium was detected during 2 weeks, 7.9±0.70mg/dL(6.5~9.2mg/dL). Patients who needed intravenous calcium, was increased during 2 weeks. 19patients(41.9%) was below 8mg/dL of serum calcium on the first day of 1st week after treatment. 21 patients(60.4%) were replaced intravenous calcium. One patient had hospitalization due to symptomatic severe hypocalcemia. After 2 months of using denosumab, serum calcium is stabilized to previous level.
Conclusion
Hypocalcemia is frequent in HD patients after use of denosumab. Intravenous calcium replacement is needed in patients with severe hypocalcemia.