Effects of clodronate in severe hyperparathyroid bone disease in chronic renal failure.
We have examined the effects of the diphosphonate, clodronate, in 9 haemodialysis patients with severe hyperparathyroid bone disease. Clodronate (300-600 mg infused after dialysis on 5 consecutive occasions) significantly decreased mean serum calcium, phosphate and hydroxyproline. This was associated with an increase in serum immunoassayable parathyroid hormone and activity of alkaline phosphatase. These changes reversed 2-4 weeks after stopping treatment but were sustained when treatment with oral clodronate (1.6 g daily) was supplemented for 2 weeks. Our findings suggest that intravenous clodronate is capable of inhibiting osteoclast-mediated bone resorption in chronic renal failure. The therapeutic potential of clodronate alone or with vitamin D derivatives merits further evaluation, particularly in patients with severe hyperparathyroidism, when the use of D metabolites alone is precluded by the presence of hypercalcaemia.
Hamdy
N A
NA
Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, UK.
McCloskey
E V
EV
Brown
C B
CB
Kanis
J A
JA
D000284:Administration, Oral; D000469:Alkaline Phosphatase / Q000097:blood; D001862:Bone Resorption / Q000188:drug therapy* / Q000209:etiology; D002118:Calcium / Q000097:blood; D004002:Clodronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D004341:Drug Evaluation; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications*; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis
D010281:Parathyroid Hormone; D004002:Clodronic Acid; D000469:Alkaline Phosphatase; D002118:Calcium