Evidence map›Paper›PMID 40650741›Full record

Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Trends in serum phosphate, calcium, and parathyroid hormone levels according to renal function following denosumab.

Jin Hyeog Lee, Seok-Jae Heo, Kyoung Min Kim, Jung Eun Lee

Abstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Jin Hyeog LeeDivision of Nephrology, Department of Internal Medicine, College of Medicine, International Saint Mary's Hospital, Catholic Kwandong University, Incheon, Republic of Korea.
Seok-Jae HeoBiostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kyoung Min KimDivision of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jung Eun LeeDivision of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. sw0615@yuhs.ac.ORCID http://orcid.org/0000-0003-0917-2872

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Denosumab affects calcium and phosphate metabolism, especially in chronic kidney disease (CKD). This study found transient calcium and phosphate reductions with parathyroid hormone (PTH) elevation, peaking at 1-3 months, especially in CKD. Levels were normalized by six months. Early monitoring and supplementation are crucial to prevent severe hypocalcemia and excessive PTH rise in CKD patients.

backgroundDenosumab is widely used for treating osteoporosis but significantly affects calcium and phosphate metabolism. Its impact on these parameters in CKD patients remains unclear.

methodsThis retrospective observational study analyzed data from three Korean hospitals, including patients treated with denosumab between November 2016 and December 2021. We assessed the mean percentage change in serum phosphate, calcium, and PTH levels from baseline to 6 months post-treatment. Among the 11,586 patients, 10,069 had normal kidney function, while 1517 had CKD.

resultsSerum phosphate levels decline temporarily but returned to baseline within six months, with no significant difference between CKD and normal groups. Serum calcium levels decline more significantly (- 6.48% vs. - 3.42%, p < 0.001) and PTH levels increase in CKD patients (200.84% vs. 124.34%, p < 0.001), especially in 1-3 months. However, calcium and PTH levels also returned to baseline by six months (- 0.76% vs. - 0.67%, p = 0.650; 24.49% vs. 20.78%, p = 0.528). Notably, hypocalcemia was more prevalent in the CKD group than in those with normal kidney function.

conclusionThis study suggests that denosumab induces a transient decrease in serum calcium and phosphate levels, accompanied by a significant increase in PTH levels, particularly during the first 1 to 3 months. Therefore, early-phase monitoring and adequate calcium and vitamin D supplementation are crucial in CKD patients to prevent severe hypocalcemia and excessive PTH elevation. Despite initial fluctuation, denosumab might be a safe treatment option for CKD patients with appropriate monitoring and management.

Indexed as

Bone Density Conservation AgentsCalciumDenosumabOsteoporosisParathyroid HormonePhosphatesRenal Insufficiency, ChronicAdultAgedAged, 80 and overFemaleGlomerular Filtration RateHumansHypocalcemiaMaleMiddle AgedBone Density Conservation AgentsCalciumDenosumabParathyroid HormonePhosphatesCalciumChronic kidney diseaseDenosumabOsteoporosisParathyroid hormonePhosphate

Identifiers

PMID40650741

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.