J Korean Soc Pediatr Nephrol > Volume 8(1); 2004 > Article
J Korean Soc Pediatr Nephrol 2004;8(1): 43-50.
장기 스테로이드 치료요법 중인 신질환 환자에서 Pamidronate의 효과
홍현기, 김은성, 김성도, 조병수
1경희대학교 의과대학 소아과교실
2경희대학교 의과대학 소아과교실
3경희대학교 의과대학 동서신장병연구소
4경희대학교 의과대학 동서신장병연구소
Efficacy of Pamidronate in Nephropathic Children with Ongoing Long Term Corticosteroid Therapy
Hyun-Kee Hong, Eun-Seong Kim, Sung-Do Kim, Byoung-Soo Cho
1Department of Pediatrics, College of Medicine, Kyunghee University
2Department of Pediatrics, College of Medicine, Kyunghee University
3East-West Kidney Disease Research Institute, College of Medicine, Kyunghee University
4East-West Kidney Disease Research Institute, College of Medicine, Kyunghee University
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Background : Steroid-induced osteoporosis(SIO) is one of the serious complications of long-term steroid therapy, especially in growing children. Recently bisphosphonates have been used to treat or prevent SIO in adult, which is rare in children with glomerular diseases. We studied the effect of pamidronate on SIO using dual energy X-ray absorptiometry and biochemical markers of bone turnover.
Methods : Forty four children receiving moderate-to-high doses of steroids were enrolled. They had no history of bone, liver, or endocrine disease. Patients were stratified by their baseline bone mineral density(BMD) findings. All patients received corticosteroids for 3 month and oral calcium supplementation(500 mg/day) daily. Among them, 28 patients were treated with placebo and 16 were treated with pamidronate(125 mg) for 3 months. Blood chemistry and bone mineral density(BMD) were measured at baseline, and 3months. In addition, parathyroid hormone(PTH), serum osteocalcin, and urinary dipyridinoline levels were evaluated.
Results : In overall population, the mean lumbar spine BMD decreased from $0.754{pm}0.211(g/cm^2)$ to $0.728{pm}0.208(g/cm^2)$ in the placebo group(P<0.05) and increased from $0.652{pm}0.194(g/cm^2)$ to $0.658{pm}0.226(g/cm^2)$ in the pamidronate group(P>0.05).
Conclusion : Pamidronate appears to be effective in preventing SIO in children with glomerular diseases requiring long-term steroids therapy. Further careful observation and follow-up might be needed for children receiving bisphosphonates such as pamidronate.
Key words: Children | Steroid-induced osteoporosis(SIO) | Glomerular diseases | Pamidronate | Bisphosphonates

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