K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease.
- Bertram L. Kasiske
- American journal of kidney diseases : the…
A 12-month prospective controlled study was conducted in 28 patients with acute osteoporotic spine fractures to evaluate and compare the effect of calcitonin treatment and cyclical hormone replacement therapy on forearm bone mineral content (BMC) and bone turnover. We established two treatment groups and a control group of women with postmenopausal osteoporosis (n=28). Group A (n=10) received 100 U of calcitonin by subcutaneous self-application on alternate days and oral calcium (Ca) for 6–8 weeks. Group B (n=10) received cyclical estrogen/gestagen replacement therapy over 12 months and oral calcium. The control group (n=8) received analgetic treatment and 500 mg Ca daily. BMC was measured by single photon absorptiometry (SPA)  with I 125 before and 6 and 12 months after the onset of the therapies. Ca, phosphorus (P), alkaline phosphatase, and 2-hour urinary OH-proline excretion were measured to classify bone turnover. One year after the onset of the two therapies, forearm BMC measured by SPA showed a significant increase in the group under hormone replacement therapy (P<0.025) as well as in the calcitonin group (P<0.05), although the latter underwent treatment only over a short period (6–8 weeks). In the same period, BMC decreased significantly in the control group (P<0.025). These results demonstrate that short-term calcitonin treatment over 6–8 weeks is as effective as long-term hormone replacement therapy, both therapies increasing forearm BMC measured by SPA.