J Korean Soc Pediatr Nephrol.  2004 Apr;8(1):43-50.

Efficacy of Pamidronate in Nephropathic Children with Ongoing Long Term Corticosteroid Therapy

• Hong HK
• Kim ES
• Kim SD
• Cho BS

Abstract

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+/-0.211 (g/cm2) to 0.728+/-0.208(g/cm2) in the placebo group(P<0.05) and increased from 0.652+/-0.194 (g/cm2) to 0.658+/-0.226(g/cm2) 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.

Keyword

Children; Steroid-induced osteoporosis(SIO); Glomerular diseases; Pamidronate; Bisphosphonates

MeSH Terms

Absorptiometry, Photon
Adrenal Cortex Hormones
Adult
Biomarkers
Calcium
Chemistry
Child*
Diphosphonates
Endocrine System Diseases
Follow-Up Studies
Humans
Liver
Osteocalcin
Spine
Steroids
Adrenal Cortex Hormones
Calcium
Diphosphonates
Osteocalcin
Steroids