scholarly journals High Normal Thyrotropin (TSH) is Associated with Higher Needed Dose of Erythropoietin in Hemodialysis Patients

2021 ◽  
pp. 49-55
Author(s):  
Ibrahim Ali Abd Elsalam Rady ◽  
Mervat Abd Elhamid Elkhateeb ◽  
Maaly Mohamed Mabrouk ◽  
Noha Elsayed Esheba
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Reference Range ◽  
Normal Reference Range ◽  
Thyrotropin Level ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Background: Recombinant human erythropoietin demonstrated an impressive ability to improve hematocrit, raising hematocrit of hemodialysis patients, eliminating the need for transfusions, and in patients with iron overload, decreased serum ferritin. Thyrotropin could affect hematopoiesis by binding to a functional thyrotropin receptor, which is found in both erythrocytes and some extrathyroidal tissues. The aim of this study was to evaluate the relationship of Thyrotropin level within normal reference range (in euthyroid state) on erythropoietin dose in end-stage renal disease patients on hemodialysis. Methods: Prospective cross-sectional study was carried out at the hemodialysis units. It included 60 patients who had end-stage renal disease on hemodialysis. The selected patients were classified into 2 groups: Group A: included 30 end-stage renal disease patients on hemodialysis with Thyrotropin level (0.4-<2.5 miu/L) and Group B: included 30 end-stage renal disease patients on hemodialysis with Thyrotropin level (2.5-4.2 miu/L). Results: the hemoglobin level and the hematocrit level showed a highly statistically significant difference between both groups. The needed Erythropiotin dosage was higher in group B than in group A with highly statistically significant difference. Weighted Erythropiotin dosage was calculated (weighted Erythropiotin=Erythropiotin dosage/weight) and the mean required dose was less than the required dose in group B and there was a highly statistically significant difference between the two groups. There was a significant negative correlation between the Thyrotropin level and hematocrit level and that leads us to conclude that the higher the Thyrotropin, the lower hematocrit will be and subsequently the higher Erythropiotin dose needed. Conclusions: There is a relationship between Thyrotropin level even within normal reference range (in euthyroid state) on erythropoietin dose in end-stage renal disease patients on hemodialysis. In other words, the higher Thyrotropin level is, the more Erythropiotin dose needed. The required erythropoietin stimulating agent dose can be predicted by measuring Thyrotropin level.

scholarly journals Dyslipidemia in End Stage Renal Disease: A Study on Dialysis Patients in Bangabandhu Sheikh Mujib Medical University Bangladesh

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hdl Cholesterol ◽  
Dialysis Patients ◽  
Ckd Stage ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
Medical University

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117

scholarly journals A comparative study of red cell folate and serum folate levels in patients on regular Hemodialysis

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Ikram Din Ujjan ◽  
Muhammad Tayyib ◽  
Tahira Tasneem ◽  
Muhammad Farooq ◽  
Muhammad Azhar Mughal ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Healthy Subjects ◽  
Serum Folate ◽  
Red Cell ◽  
Group A ◽  
Level Of Significance ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Sixty subjects were selected and were divided into two groups. Group A included 30 patients of end stage renal disease on regular dialysis and group B included 30 normal healthy subjects as control. Absolute values and Hb were done by hematology auto analyzer and serum and red cell folate were done by commercially available kits. Results were analyzed by using Student`s `t` test and level of significance was done. A significant decreased in serum and red cell folate in end stage renal disease patients with regular dialysis as compared to control.

scholarly journals END STAGE RENAL DISEASE

2018 ◽  
Vol 25 (05) ◽  
pp. 728-734
Author(s):  
Muhammad Hussain Baloch ◽  
Nadia Shams ◽  
Najia Mahmood ◽  
Warda Zahoor ◽  
Naresh Kumar Seetlani ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hematological Parameters ◽  
Additional Risk Factor ◽  
Chi Square ◽  
Hematological Profile ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Objectives: To study hematological profile in geriatric cases undergoinghemodialysis and compare with non-geriatric. Study Design: Descriptive Cross SectionalStudy. Setting: Department of Nephrology & Medicine, Rawal Institute of Health SciencesIslamabad. Study Duration: 12 months (June 2016-June 2017). Material and Methods: Adultpatients (>18years) diagnosed as end stage renal disease (ESRD), undergoing maintenancehemodialysis for >3 months included after ethical approval and consent. Group A had 88geriatric ESRD cases (>65 years); group B had 88 non-geriatric (<65 years). Data analyzedby SPSS version 17. Hematological profile and other variables compared between two groupsby Chi-Square and t-test (significant p<0.05). Results: Among 166 ESRD cases (69% malesand 31% females), mean age was 54.9+10.6 years. Anemia present in 89% (group A) vs.74% (group B; p=0.012). Mean hemoglobin was 8.57+2.00 (group A) vs. 9.27+2.39 (groupB; p=0.035). Mean platelets count was lower among geriatrics; however leukocyte countscomparable between two groups. Mean eGFR was 7.95+2.68 (group A) vs. 9.16+4.04(group B; p=0.020). Diabetes and hypertension were frequent in geriatric group (p<0.05).No difference in hepatitis B, C and congestive cardiac failure observed. BMI was 26.74+5.87(group A) vs. 22.43+4.83 (group B; p<0.0001). Lack of social support observed in 25% (groupA) vs. 9% (group B). Conclusion: Anemia is frequent observation in ESRD hemodialysis cases.Geriatric ESRD hemodialysis cases have significantly low hemoglobin levels than non-geriatric.Hence, suggested that old age to be considered as an additional risk factor for anemia in ESRDhemodialysis cases. Geriatric ESRD hemodialysis cases should undergo frequent anemiascreening and timely intervention. Iron supplementation, dietary modification, erythropoietinadministration and blood transfusion as per indication needs to be individualized in geriatriccases to improve hematological parameters and quality of life.

Sustained complete renal remission is a predictor of reduced mortality, chronic kidney disease and end-stage renal disease in lupus nephritis

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 468-474 ◽  
Author(s):  
R Pakchotanon ◽  
D D Gladman ◽  
J Su ◽  
M B Urowitz
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Renal Outcome ◽  
Renal Flare ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Objective The objective of this paper is to identify the relationship between patients with lupus nephritis (LN) who achieve sustained complete renal remission (CR) and renal outcome and survival. Methods From a longitudinal cohort study we identified patients with LN with CR. We compared the outcomes of patients who achieved sustained CR for at least five years (Group A) with those less than five years (Group B). The outcomes were death, SLICC/ACR damage index (SDI), renal flare, end-stage renal disease (ESRD) or estimated glomerular filtration rate (eGFR) < 50 ml/min, and doubling of serum creatinine. Regression analyses were used to identify predictors of the outcomes. Results A total of 345 patients were identified, 132 patients in Group A and 213 patients in Group B. The duration of CR in Group A was 11.76 ± 7.34 years but only 1.24 ± 1.24 years in Group B ( p < 0.001). Death, increasing renal SDI, renal flare, renal transplantation, ESRD or eGFR < 50 ml/min, and doubling of serum creatinine in Group A were significantly lower than Group B. Multivariable analysis revealed that Group A patients were at a lower risk of death (hazard ratio (HR) = 0.20; 95% confidence interval (CI), 0.07–0.61; p = 0.004), increasing renal SDI (HR = 0.41; 95% CI, 0.21–0.76; p = 0.01), developing ESRD or eGFR < 50 ml/min (HR = 0.27; 95% CI, 0.12–0.61; p = 0.001), and doubling of serum creatinine (HR = 0.29; 95% CI, 0.14–0.61; p = 0.001) compared with Group B. Conclusion Sustained CR for at least five years is a predictor of better prognosis in patients with LN.

scholarly journals Risk Reduction for End-Stage Renal Disease by Dietary Guidance Using the Gustatory Threshold Test for Salty Taste

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2703
Author(s):  
Yuki Ota ◽  
Mineaki Kitamura ◽  
Kiyokazu Tsuji ◽  
Kenta Torigoe ◽  
Ayuko Yamashita ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
University Hospital ◽  
Salt Reduction ◽  
Induction Rate ◽  
Salty Taste ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Educational hospitalization of patients with chronic kidney disease (CKD) may slow the progression of renal dysfunction. However, the educational aspect that is more effective has not been identified to date. In this study, patients with CKD were evaluated for gustatory threshold for salty taste and received augmented salt reduction guidance under educational hospitalization at Nagasaki University Hospital from October 2016. In total, 277 eligible patients were enrolled and hospitalized from 2012 to 2019 (mean age of 69.2 years; men comprised 62.1%). We compared 141 patients (Group A) who were educated in the hospital after October 2016 and 136 patients (Group B) who received standard education in the hospital before October 2016. The changes in the estimated glomerular filtration rate (ΔeGFR) after hospitalization and dialysis induction rate within one year after hospitalization were evaluated. The ΔeGFR was significantly improved in Group A compared to Group B (A: 1.05 mL/min/1.73 m2/month, B: 0.55 mL/min/1.73 m2/month; p = 0.02). The dialysis induction rate was significantly lower in Group A than in Group B (A: 8.5%, B: 15.5%; p = 0.001). These trends were also observed by multivariate analyses. In conclusion, educational hospitalization with enhanced salt reduction guidance may reduce the risk of end-stage renal disease.

scholarly journals The Profile of Timing Dialysis Initiation in Patients with End-stage Renal Disease in China: A Cohort Study

2020 ◽  
Vol 45 (2) ◽  
pp. 180-193
Author(s):  
Ying Liu ◽  
Luping Wang ◽  
Xianfeng Han ◽  
Yang Wang ◽  
Xuefeng Sun ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Mainland China ◽  
Dialysis Initiation ◽  
Significant Difference ◽  
Initiation Of Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Background: Hemodialysis is the main approach for renal replacement therapy in patients with end-stage renal disease (ESRD) in China. The timing of dialysis initiation is one of the key factors influencing patient survival and prognosis. Over the past decade, the relationship between the timing of dialysis initiation and mortality has remained unclear in patients with ESRD in China. Methods: Patients who commenced maintenance hemodialysis from 2009 to 2014 from 24 hemodialysis centers in Mainland China were enrolled in the study (n = 1,674). Patients were divided into 2 groups based on the year they started hemodialysis (patients who started hemodialysis from 2009 to 2011, and patients who started hemodialysis from 2012 to 2014). Analysis of the yearly change in the estimated glomerular filtration rate (eGFR) at the initiation of dialysis was performed for the 2 groups. Meanwhile, the patients were divided into 3 groups based on their eGFR at the initiation of dialysis (<4, 4–8, and >8 mL/min/1.73 m2). For these 3 groups, the relationship between the eGFR at the start of dialysis and mortality were analyzed. Results: The average eGFRs were 5.68 and 5.94 mL/min/1.73 m2 for 2009–2011 and 2012–2014, respectively. Compared with the 2009–2011 group, the proportion of patients with diabetes in 2012–2014 increased from 26.7 to 37.7%. The prognosis of patients with different eGFRs at the start of dialysis was analyzed using Kaplan-Meier survival curves. After adjusting for confounding factors through a Cox regression model, no significant difference was demonstrated among the 3 groups (<4 mL/min/1.73 m2 was used as the reference, in comparison with 4–8 mL/min/1.73 m2 [p = 0.681] and >8 mL/min/1.73 m2 [p = 0.403]). Conclusion: In Mainland China, the eGFR at the start of dialysis did not change significantly over time from 2008 to 2014 and had no association with the mortality of patients with ESRD.

scholarly journals P1541HEMODIALYSIS IN END-STAGE RENAL DISEASE PATIENTS OVER 75 YEARS OLD

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tasnim Mesbahi ◽  
Barbouch Samia ◽  
Fattoum Safa ◽  
Najjar Mariem ◽  
Jebali Hela ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Older Patients ◽  
Cox Model ◽  
Dialysis Initiation ◽  
First Year ◽  
Younger Patients ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Over the last decade, the age of dialysis patients has been increasing steadily worldwide. The benefits of dialysis in older people with end stage renal disease (ESRD) are not clear. We will try to evaluate whether dialysis in older has survival advantage compared to younger people. Method It is a prospective descriptive and analytic study including 229 patients who initiated chronic hemodialysis during the period between January and June 2017. Patients were classified into two groups by age at dialysis initiation. Patients above 75 years of age were considered old (old group OG). Patients aged less then 75 years old were considered young (young group YG). Primary outcome was old patient’s survival during the first 3 and 12 months from the dialysis initiation. Results Among a total of 229 new patients who began dialysis treatment, 41 (17,9%) ESRD were above 75 years of age.The sex ratio was 0,95 and 1,54 in respectively in OG and YG (p = 0,167). Diabetes was present in 56% of the elderly and in 59% of the younger group (p = 0,72) and was more frequently the cause of ESRD in the two groups. The average of modified Charlson Comorbidity Index was 6,7 ± 2,3 and 3,9 ± 2,6 respectively in OG and YG(p = 10-3). Younger patients had been referred earlier to nephrologists than the older ones. In fact, glomerular filtration rate at the beginning of the follow up was 18,7 ± 8,9 ml/min/1,73 in OG and 25,4 ± 16,2 in YG (p = 0,004). There was no statically significant difference between the two groups in the frequency of the use of temporary catheters at dialysis initiation (p = 0,778) and the urgent or planned initiation of dialysis (p = 0,298). Younger patients required hospitalization to organize dialysis initiation more than older patients (51,6% VS 26,8%; p = 0,005). Compared with the group of younger patients, Cox model showed an incremental increase in mortality associated with older patients’ group during the first year of HD (p = 0,036). However, there was no difference between OG and YG in the mortality rate during the first 3 months of HD (p = 0,102). Conclusion We may conclude that life expectancy of patients who began dialysis above 75 years is significantly shorter than younger patients in the first year of HD. In the other hand, the difference between the 2 groups wasn’t significant regarding the conditions of dialysis initiation.

The Success Story of Peritoneal Dialysis in Romania: Analysis of Differences in Mortality by Dialysis Modality and Influence of Risk Factors in a National Cohort

2006 ◽  
Vol 26 (2) ◽  
pp. 266-275 ◽  
Author(s):  
Gabriel Mircescu ◽  
Liliana Garneata ◽  
Laura Florea ◽  
Vasile Cepoi ◽  
Dimitrie Capsa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Comorbid Conditions ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Background This report describes the status of renal replacement therapy (RRT), particularly continuous ambulatory peritoneal dialysis (CAPD), in Romania (a country with previously limited facilities), outlines the fast development rate of CAPD, and presents national changes in a European context. Methods Trends in the development of RRT were analyzed in 2003 on a national basis using annual center questionnaires from 1995 to 2003. Survival data and prognostic risk factors were calculated retrospectively from a representative sample of 2284 patients starting RRT between 1 January 1995 and 31 December 2001 (44% of the total RRT population investigated). Results The annual rate of increase in the number of RRT patients (11%) was supported mainly by an exponential development of the CAPD population (+600%); the hemodialysis (HD) growth rate was stable (+33%) and renal transplantation had a marginal contribution. The characteristics of both HD and PD incident patients changed according to current European epidemiology (increasing age and prevalence of diabetes and nephroangiosclerosis). There were significant differences between PD and HD incident populations, PD patients being significantly older and having a higher prevalence of diabetic nephropathy and baseline comorbidities, probably reflecting different inclusion policies. The estimated overall survival of RRT patients in Romania was 90.6% at 1 year [confidence interval (CI) 89.4 – 91.8] and 62.2% at 5 years (CI 59.4 – 65.0). The initial treatment modality did not significantly influence patients’ survival. There was no difference in unadjusted technique survival during the first 2 years; afterwards, there was a clear advantage for HD, with more patients being transferred from PD to HD. Several factors seemed to significantly and negatively influence PD patients’ survival (Cox regression analysis): male gender, lack of predialysis erythropoietin treatment, and initial comorbidities. Stratified analysis to discover the influence of these factors on patients’ survival revealed that HD was associated with an increased risk of death in the younger nondiabetic end-stage renal disease population, regardless of other coexisting comorbid conditions. However, in older patients (>65 years) and in diabetics, regardless of the presence or absence of associated comorbid conditions, there was no significant difference in death rates between HD and PD patients. Conclusions We report an impressive quantitative and qualitative development of CAPD in one of the rapidly growing Central and Eastern Europe countries. CAPD should be the method of choice for young nondiabetic end-stage renal disease patients. Improvement in predialysis nephrologic care and in transplantation rates is required to further ensure the ultimate success of the Romanian PD program.

Reviews and Original Articles Lipoprotein(A) and Apolipoprotein(A) Phenotypes in Patients with End-Stage Renal Disease

1997 ◽  
Vol 17 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Soon Bae Kim ◽  
Won Seok Yang ◽  
Eun Suk Kang ◽  
Won Ki Min ◽  
Jung Sik Park
Keyword(s):  
Molecular Weight ◽  
Renal Disease ◽  
Serum Albumin ◽  
High Molecular Weight ◽  
End Stage Renal Disease ◽  
Lipoprotein A ◽  
Apolipoprotein A ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Objective To evaluate the distribution pattern of apolipoprotein(a) [Apo(a)] phenotypes in Koreans and the effect of dialysis modality on serum lipoprotein(a) [Lp(a)] concentration according to apo(a) phenotype in patients with end-stage renal disease (ESRO). Design Cross-sectional study. Setting A university hospital. Participants: 153 normal controls, 99 hemodialysis (HO) patients and 82 continuous ambulatory peritoneal dialysis (CAPO) patients. Main Outcome Measures Fasting serum Lp(a), lipids, and apo(a) phenotypes were measured. Results The frequencies of the subjects with apo(a) phenotypes of high-molecular weight only, including S3, S4, or S5 or null type were 95.4% of control, 100% of HO patients, and 95.1% of CAPO patients. The frequent apo(a) phenotypes in Koreans consisted of S4, S4S5, S5, and S5S5 isoforms. Significant difference was found in serum Lp(a) concentration among controls and HO and CAPO patients [median (interquartile range): 0.05 g/L, (0.01 0.19); 0.19g/L, (0.10 0.35); 0.63g/L, (0.28 0.90), p< 0.001]. Lp(a) levels in CAPO patients were significantly higher than in HO patients for all four common apo(a) isoforms found in Korean subjects. CAPO patients had higher total and LOL cholesterol levels, and higher ApoB levels than H O patients. Significant differences were found in serum albumin levels between controls and HO and CAPO patients (44 ± 3 g/L, 40 ± 4 g/L, 32 ± 7 g/L, respectively, p < 0.05). There were significant inverse correlations between serum albumin and Lp(a) (r = -0.33, p < 0.01), total cholesterol (r = -0.31, p < 0.01), LOL (r = -0.39, p < 0.01) or ApoB (r = -0.35, p < 0.01) in ESRO patients. A significant positive correlation was found between serum albumin and ApoA1 (r = 0.24, p < 0.01). Conclusion These findings indicate that Koreans have mainly high -molecular weight apo(a) phenotypes and serum Lp(a) is elevated in CAPO patients compared to HO patients for common apo(a) phenotypes, which may contribute to the frequent cardiovascular mortality in CAPO patients.

scholarly journals Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 730-737
Author(s):  
Hao-Yang Ma ◽  
Shuang Chen ◽  
Ling-Ling Lu ◽  
Wei Gong ◽  
Ai-Hua Zhang
Keyword(s):  
Lumbar Spine ◽  
Renal Disease ◽  
Postmenopausal Women ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

AbstractAs a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

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