December 13, 2024

Bone density medication found to be safe and effective in most women with CKD, with some caveats

A review of multiple clinical trials suggests that a medication used to increase bone density in people living with chronic kidney disease (CKD) can benefit bone health without compromising kidney health. However, the results show that some people with moderate kidney disease did experience an increased risk of fractures despite the medication, and that the medication is associated with an increased risk of low calcium across all study participants, despite their kidney disease stage.  

Kidney disease is associated with an increased risk of fractures and related complications. A class of medication called bisphosphonates are is sometimes used to help increase bone density in people at high risk of fractures, but their safety and effectiveness in people with CKD is not well known. To gain more insights, Reid Whitlock and colleagues analyzed a collection of seven large randomized clinical trials evaluating the effects of ibandronate, a common medication to increase bone density, in more than 7,400 participants. It’s important to note that these studies involved exclusively women and did not include many patients with advanced kidney disease. 

The results show that, overall, ibandronate increased the bone density of CKD patients’ hips and lower spine, andspine and decreased their risk of fracture. However, in a small subset of patients— – those with stage G3B CKD— – the medication was associated with an increased the risk of fracture. The reasons for this difference are not clear but may be related to overtreatment of bone disease related to kidney disease. The results also show that, while ibandronate did not appear to exacerbate kidney disease, it was associated with an increased risk of low calcium. The researchers emphasize that more research is needed to explore these findings in greater detail.