The effects of estrogen on renal osteodystrophy in the female patients undergoing maintenance hemodialysis

• Published in: Nihon Jinzo Gakkai shi Vol. 28; no. 8; pp. 1129 - 1136
• Main Authors: AKINO, HIRONOBU, SAITO, AKIHIRO, MAEDA, SHINICHI, KITAJIMA, WAICHI, OKANO, MANABU, ISOMATSU, YUKISHIGE, MURANAKA, KOJI, KANIMOTO, YUSUKE, SHIMIZU, YASUO, KAWADA, YUKIMICHI
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 1986
• Subjects: Adult; Bone Resorption - drug effects; Calcitriol - blood; Chronic Kidney Disease-Mineral and Bone Disorder - blood; Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy; Chronic Kidney Disease-Mineral and Bone Disorder - etiology; estrogen; Estrogens - therapeutic use; Female; Humans; Kidney Failure, Chronic - complications; Menopause; Middle Aged; Renal Dialysis - adverse effects; renal osteodystrophy
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.28.1129

The effect of estrogen on renal osteodystrophy (ROD) in the female patients undergoing maintenance hemodialysis has been poorly understood. In this study, we investigated the role of estrogen on ROD in the premenopausal and postmenopausal patients, and the effect of estrogen on bone metabolism by the administration of estriol (2m;/day) to the postmeno-pausal patients. The following results were obtained. 1) The magnitude of parathyroid hormone (PTH) induced bone resorption was greater in the postmenopausal patients than in the premenopausal patients. Furthermore, the serum level of 1, 25 (OH)2D3 was lower in the postmenopausal patients than in the premenopausal patients. These results were considered to be due to lack of estrogen in the postmenopausal patients. 2) The serum levels of phosphorus and ALP were significantly decreased in the post. menopausal patients by the administration of estriol, which resulted from the inhibition of PTH induced bone resorption owing to estrogen. But, when the period of the administration exeeded one month, secondary hyperparathyroidism was conversely aggravated. The cause of this aggravation was considered to be lack of calcium. Therefore, we considered that the combination therapy of estrogen and 1α(OH)D3 was reasonable in the treatment of ROD in the postmenopausal patients. 3) The serum level of 1, 25(OH)2D3 was significantly increased in 3 patients of 8 post. menopausal ones by the administration of estriol. From the above results, we were deeply impressed that the estrogen played the impor-tant role on ROD in postmenopausal state.