Osteopenia in Patients with Glomerular Diseases Requiring Long-Term Corticosteroid Therapy
Background: Chronic corticosteroid (CS) use is associated with bone mass loss. Methods: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal functi...
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description | Background: Chronic corticosteroid (CS) use is associated with bone mass loss. Methods: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal function, who were taking CS, as prednisone and/or methylprednisolone, in doses ≧7.5 mg/day, for a period of at least 6 months. Cumulative dose and duration of prior CS therapy, as well as biochemical parameters and other factors contributing to bone loss were evaluated. Results: We found 37 (52%) patients with low BMD (29 with osteopenia and 8 with osteoporosis). The low BMD group presented a lower mean weight and body mass index (BMI) versus the normal BMD group (62 ± 15 vs. 70 ± 10 kg and 25 ± 4 vs. 27 ± 5, mean ± SD, p < 0.05). The estimated calcium intake was lower than 400 mg/day in all patients with low BMD, and they had taken furosemide as a concomitant drug for a longer mean period of time when compared to normal BMDpatients (30 ± 29 vs. 16 ± 27 months, p < 0.05). A higher mean number of pulses per patient and mean cumulative dose of methylprednisolone were observed in the low versus normal BMD group (7.7 ± 4.0 vs. 5.6 ± 4.0 pulses and 6.5 ± 3.9 vs. 3.9 ± 2.7 g, p < 0.05). Conclusions: These findings suggest a high frequency of osteopenia among young and premenopausal patients with glomerular diseases given long-term corticosteroid therapy. The lower BMI and calcium intake, as well as the concomitant furosemide use, might have contributed to such a bone loss. The higher number of pulse therapies leading to higher cumulative intravenous doses of corticosteroid mainly in lupus nephritis patients shows that pulse therapy may be deleterious to bone. |
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Methods: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal function, who were taking CS, as prednisone and/or methylprednisolone, in doses ≧7.5 mg/day, for a period of at least 6 months. Cumulative dose and duration of prior CS therapy, as well as biochemical parameters and other factors contributing to bone loss were evaluated. Results: We found 37 (52%) patients with low BMD (29 with osteopenia and 8 with osteoporosis). The low BMD group presented a lower mean weight and body mass index (BMI) versus the normal BMD group (62 ± 15 vs. 70 ± 10 kg and 25 ± 4 vs. 27 ± 5, mean ± SD, p < 0.05). The estimated calcium intake was lower than 400 mg/day in all patients with low BMD, and they had taken furosemide as a concomitant drug for a longer mean period of time when compared to normal BMDpatients (30 ± 29 vs. 16 ± 27 months, p < 0.05). A higher mean number of pulses per patient and mean cumulative dose of methylprednisolone were observed in the low versus normal BMD group (7.7 ± 4.0 vs. 5.6 ± 4.0 pulses and 6.5 ± 3.9 vs. 3.9 ± 2.7 g, p < 0.05). Conclusions: These findings suggest a high frequency of osteopenia among young and premenopausal patients with glomerular diseases given long-term corticosteroid therapy. The lower BMI and calcium intake, as well as the concomitant furosemide use, might have contributed to such a bone loss. The higher number of pulse therapies leading to higher cumulative intravenous doses of corticosteroid mainly in lupus nephritis patients shows that pulse therapy may be deleterious to bone.</description><identifier>ISSN: 0028-2766</identifier><identifier>ISSN: 1660-2110</identifier><identifier>ISSN: 1660-8151</identifier><identifier>EISSN: 1660-2110</identifier><identifier>EISSN: 2235-3186</identifier><identifier>DOI: 10.1159/000072023</identifier><identifier>PMID: 12902633</identifier><identifier>CODEN: NPRNAY</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Adrenal Cortex Hormones - adverse effects ; Adrenal Cortex Hormones - therapeutic use ; Adult ; Anti-Inflammatory Agents - administration & dosage ; Anti-Inflammatory Agents - adverse effects ; Anti-Inflammatory Agents - therapeutic use ; Biological and medical sciences ; Bone Density - drug effects ; Bone Diseases, Metabolic - blood ; Bone Diseases, Metabolic - chemically induced ; Calcium - blood ; Calcium - metabolism ; Drug Administration Schedule ; Drug toxicity and drugs side effects treatment ; Female ; Femur Neck - chemistry ; Femur Neck - drug effects ; Femur Neck - pathology ; Humans ; Infusions, Intravenous ; Kidney Diseases - blood ; Kidney Diseases - drug therapy ; Kidney Diseases - etiology ; Lumbar Vertebrae - chemistry ; Lumbar Vertebrae - drug effects ; Lumbar Vertebrae - pathology ; Lupus Erythematosus, Systemic - complications ; Lupus Erythematosus, Systemic - pathology ; Male ; Medical sciences ; Methylprednisolone - administration & dosage ; Methylprednisolone - adverse effects ; Methylprednisolone - therapeutic use ; Original Paper ; Pharmacology. Drug treatments ; Prednisone - administration & dosage ; Prednisone - adverse effects ; Prednisone - therapeutic use ; Pulse Therapy, Drug - adverse effects ; Pulse Therapy, Drug - methods ; Toxicity: osteoarticular system</subject><ispartof>Nephron, 2003-07, Vol.94 (3), p.c69-c74</ispartof><rights>2003 S. Karger AG, Basel</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2003 S. Karger AG, Basel</rights><rights>Copyright S. Karger AG Jul 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-eb6d831bc5aa000a91375d5855101a2ee968a5c1c957a020d9521ed788077d833</citedby><cites>FETCH-LOGICAL-c416t-eb6d831bc5aa000a91375d5855101a2ee968a5c1c957a020d9521ed788077d833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,2423,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15043677$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12902633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barbosa de Deus, Rogério</creatorcontrib><creatorcontrib>Conde Ferreira, Alessandra</creatorcontrib><creatorcontrib>Mastroianni Kirsztajn, Gianna</creatorcontrib><creatorcontrib>Pfeferman Heilberg, Ita</creatorcontrib><title>Osteopenia in Patients with Glomerular Diseases Requiring Long-Term Corticosteroid Therapy</title><title>Nephron</title><addtitle>Nephron Clin Pract</addtitle><description>Background: Chronic corticosteroid (CS) use is associated with bone mass loss. Methods: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal function, who were taking CS, as prednisone and/or methylprednisolone, in doses ≧7.5 mg/day, for a period of at least 6 months. Cumulative dose and duration of prior CS therapy, as well as biochemical parameters and other factors contributing to bone loss were evaluated. Results: We found 37 (52%) patients with low BMD (29 with osteopenia and 8 with osteoporosis). The low BMD group presented a lower mean weight and body mass index (BMI) versus the normal BMD group (62 ± 15 vs. 70 ± 10 kg and 25 ± 4 vs. 27 ± 5, mean ± SD, p < 0.05). The estimated calcium intake was lower than 400 mg/day in all patients with low BMD, and they had taken furosemide as a concomitant drug for a longer mean period of time when compared to normal BMDpatients (30 ± 29 vs. 16 ± 27 months, p < 0.05). A higher mean number of pulses per patient and mean cumulative dose of methylprednisolone were observed in the low versus normal BMD group (7.7 ± 4.0 vs. 5.6 ± 4.0 pulses and 6.5 ± 3.9 vs. 3.9 ± 2.7 g, p < 0.05). Conclusions: These findings suggest a high frequency of osteopenia among young and premenopausal patients with glomerular diseases given long-term corticosteroid therapy. The lower BMI and calcium intake, as well as the concomitant furosemide use, might have contributed to such a bone loss. The higher number of pulse therapies leading to higher cumulative intravenous doses of corticosteroid mainly in lupus nephritis patients shows that pulse therapy may be deleterious to bone.</description><subject>Adrenal Cortex Hormones - adverse effects</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Anti-Inflammatory Agents - adverse effects</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bone Density - drug effects</subject><subject>Bone Diseases, Metabolic - blood</subject><subject>Bone Diseases, Metabolic - chemically induced</subject><subject>Calcium - blood</subject><subject>Calcium - metabolism</subject><subject>Drug Administration Schedule</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Femur Neck - chemistry</subject><subject>Femur Neck - drug effects</subject><subject>Femur Neck - pathology</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Kidney Diseases - blood</subject><subject>Kidney Diseases - drug therapy</subject><subject>Kidney Diseases - etiology</subject><subject>Lumbar Vertebrae - chemistry</subject><subject>Lumbar Vertebrae - drug effects</subject><subject>Lumbar Vertebrae - pathology</subject><subject>Lupus Erythematosus, Systemic - complications</subject><subject>Lupus Erythematosus, Systemic - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Methylprednisolone - adverse effects</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Original Paper</subject><subject>Pharmacology. Drug treatments</subject><subject>Prednisone - administration & dosage</subject><subject>Prednisone - adverse effects</subject><subject>Prednisone - therapeutic use</subject><subject>Pulse Therapy, Drug - adverse effects</subject><subject>Pulse Therapy, Drug - methods</subject><subject>Toxicity: osteoarticular system</subject><issn>0028-2766</issn><issn>1660-2110</issn><issn>1660-8151</issn><issn>1660-2110</issn><issn>2235-3186</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpt0MFrFDEUBvAgil2rB8-CBEHBw2heZpNMjmVta2GxpawXL8PbzNtt6sxkmswg_e8b3aUL0lxC4JeXLx9jb0F8AVD2q8jLSCHLZ2wGWotCAojnbCaErApptD5ir1K6zUcJwr5kRyCtkLosZ-zXZRopDNR75L7nVzh66sfE__jxhp-3oaM4tRj5N58IEyV-TXeTj77f8mXot8WKYscXIY7ehTwpBt_w1Q1FHO5fsxcbbBO92e_H7OfZ6WrxvVhenl8sTpaFm4MeC1rrpiph7RRi_gdaKI1qVKUUCEBJZHWFyoGzyqCQorFKAjWmqoQx-WZ5zD7t5g4x3E2UxrrzyVHbYk9hSrUUVmgoZYYf_oO3YYp9zlZLM58DlGAz-rxDLoaUIm3qIfoO430Nov7bdv3Ydrbv9wOndUfNQe7rzeDjHmBy2G4i9s6ng1NiXmpjDsl-Y9xSfAQ_Thf_XqqHZpPRuyfRLssDDcSZpQ</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Barbosa de Deus, Rogério</creator><creator>Conde Ferreira, Alessandra</creator><creator>Mastroianni Kirsztajn, Gianna</creator><creator>Pfeferman Heilberg, Ita</creator><general>Karger</general><general>S. Karger AG</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>S0X</scope><scope>7QP</scope></search><sort><creationdate>20030701</creationdate><title>Osteopenia in Patients with Glomerular Diseases Requiring Long-Term Corticosteroid Therapy</title><author>Barbosa de Deus, Rogério ; Conde Ferreira, Alessandra ; Mastroianni Kirsztajn, Gianna ; Pfeferman Heilberg, Ita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-eb6d831bc5aa000a91375d5855101a2ee968a5c1c957a020d9521ed788077d833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adrenal Cortex Hormones - adverse effects</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Adult</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Anti-Inflammatory Agents - adverse effects</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bone Density - drug effects</topic><topic>Bone Diseases, Metabolic - blood</topic><topic>Bone Diseases, Metabolic - chemically induced</topic><topic>Calcium - blood</topic><topic>Calcium - metabolism</topic><topic>Drug Administration Schedule</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Femur Neck - chemistry</topic><topic>Femur Neck - drug effects</topic><topic>Femur Neck - pathology</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Kidney Diseases - blood</topic><topic>Kidney Diseases - drug therapy</topic><topic>Kidney Diseases - etiology</topic><topic>Lumbar Vertebrae - chemistry</topic><topic>Lumbar Vertebrae - drug effects</topic><topic>Lumbar Vertebrae - pathology</topic><topic>Lupus Erythematosus, Systemic - complications</topic><topic>Lupus Erythematosus, Systemic - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Methylprednisolone - adverse effects</topic><topic>Methylprednisolone - therapeutic use</topic><topic>Original Paper</topic><topic>Pharmacology. Drug treatments</topic><topic>Prednisone - administration & dosage</topic><topic>Prednisone - adverse effects</topic><topic>Prednisone - therapeutic use</topic><topic>Pulse Therapy, Drug - adverse effects</topic><topic>Pulse Therapy, Drug - methods</topic><topic>Toxicity: osteoarticular system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barbosa de Deus, Rogério</creatorcontrib><creatorcontrib>Conde Ferreira, Alessandra</creatorcontrib><creatorcontrib>Mastroianni Kirsztajn, Gianna</creatorcontrib><creatorcontrib>Pfeferman Heilberg, Ita</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SIRS Editorial</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>Nephron</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barbosa de Deus, Rogério</au><au>Conde Ferreira, Alessandra</au><au>Mastroianni Kirsztajn, Gianna</au><au>Pfeferman Heilberg, Ita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Osteopenia in Patients with Glomerular Diseases Requiring Long-Term Corticosteroid Therapy</atitle><jtitle>Nephron</jtitle><addtitle>Nephron Clin Pract</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>94</volume><issue>3</issue><spage>c69</spage><epage>c74</epage><pages>c69-c74</pages><issn>0028-2766</issn><issn>1660-2110</issn><issn>1660-8151</issn><eissn>1660-2110</eissn><eissn>2235-3186</eissn><coden>NPRNAY</coden><abstract>Background: Chronic corticosteroid (CS) use is associated with bone mass loss. Methods: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal function, who were taking CS, as prednisone and/or methylprednisolone, in doses ≧7.5 mg/day, for a period of at least 6 months. Cumulative dose and duration of prior CS therapy, as well as biochemical parameters and other factors contributing to bone loss were evaluated. Results: We found 37 (52%) patients with low BMD (29 with osteopenia and 8 with osteoporosis). The low BMD group presented a lower mean weight and body mass index (BMI) versus the normal BMD group (62 ± 15 vs. 70 ± 10 kg and 25 ± 4 vs. 27 ± 5, mean ± SD, p < 0.05). The estimated calcium intake was lower than 400 mg/day in all patients with low BMD, and they had taken furosemide as a concomitant drug for a longer mean period of time when compared to normal BMDpatients (30 ± 29 vs. 16 ± 27 months, p < 0.05). A higher mean number of pulses per patient and mean cumulative dose of methylprednisolone were observed in the low versus normal BMD group (7.7 ± 4.0 vs. 5.6 ± 4.0 pulses and 6.5 ± 3.9 vs. 3.9 ± 2.7 g, p < 0.05). Conclusions: These findings suggest a high frequency of osteopenia among young and premenopausal patients with glomerular diseases given long-term corticosteroid therapy. The lower BMI and calcium intake, as well as the concomitant furosemide use, might have contributed to such a bone loss. The higher number of pulse therapies leading to higher cumulative intravenous doses of corticosteroid mainly in lupus nephritis patients shows that pulse therapy may be deleterious to bone.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>12902633</pmid><doi>10.1159/000072023</doi><tpages>1</tpages></addata></record> |
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subjects | Adrenal Cortex Hormones - adverse effects Adrenal Cortex Hormones - therapeutic use Adult Anti-Inflammatory Agents - administration & dosage Anti-Inflammatory Agents - adverse effects Anti-Inflammatory Agents - therapeutic use Biological and medical sciences Bone Density - drug effects Bone Diseases, Metabolic - blood Bone Diseases, Metabolic - chemically induced Calcium - blood Calcium - metabolism Drug Administration Schedule Drug toxicity and drugs side effects treatment Female Femur Neck - chemistry Femur Neck - drug effects Femur Neck - pathology Humans Infusions, Intravenous Kidney Diseases - blood Kidney Diseases - drug therapy Kidney Diseases - etiology Lumbar Vertebrae - chemistry Lumbar Vertebrae - drug effects Lumbar Vertebrae - pathology Lupus Erythematosus, Systemic - complications Lupus Erythematosus, Systemic - pathology Male Medical sciences Methylprednisolone - administration & dosage Methylprednisolone - adverse effects Methylprednisolone - therapeutic use Original Paper Pharmacology. Drug treatments Prednisone - administration & dosage Prednisone - adverse effects Prednisone - therapeutic use Pulse Therapy, Drug - adverse effects Pulse Therapy, Drug - methods Toxicity: osteoarticular system |
title | Osteopenia in Patients with Glomerular Diseases Requiring Long-Term Corticosteroid Therapy |
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