Romosozumab successfully regulated progressive osteoporosis in a patient with autosomal dominant polycystic kidney disease undergoing hemodialysis

Osteoporos Int. 2022 Dec;33(12):2649-2652. doi: 10.1007/s00198-022-06534-4. Epub 2022 Aug 18.

Abstract

Osteoporosis is a crucial complication in patients with chronic kidney disease (CKD), similar to that in the general population. Although romosozumab, a monoclonal antibody targeting sclerostin, has been administered for patients with CKD, its clinical effectiveness in these patients, especially in patients on hemodialysis (HD), remains to be studied. Herein, we report the case of a 42-year-old man on HD who developed severe osteoporosis. Serum calcium levels were extremely high, bone metabolic markers were abnormal, and the patient had pathological fractures. The bone biopsy indicated a bone metabolism disorder and high bone turnover. We administered romosozumab once a month as an intervention for bone alteration. Through the 10-month usage, bone metabolic markers improved, and the decrease in bone mineral density was ameliorated. We hypothesized that romosozumab could be a therapeutic option for osteoporosis in patients undergoing HD, especially in those with bone mineralization disorders.

Keywords: CKD-MBD; Hemodialysis; Osteoporosis; Renal osteodystrophy; Romosozumab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use
  • Bone Density
  • Bone Density Conservation Agents* / therapeutic use
  • Bone Diseases*
  • Humans
  • Osteoporosis* / drug therapy
  • Osteoporosis* / etiology
  • Osteoporosis* / metabolism
  • Polycystic Kidney, Autosomal Dominant* / drug therapy
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / drug therapy
  • Renal Insufficiency, Chronic* / therapy

Substances

  • romosozumab
  • Antibodies, Monoclonal
  • Bone Density Conservation Agents