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Calcitriol: a better option than vitamin D in denosumab-treated patients with kidney failure?

机译:骨化三醇:对地诺单抗治疗的肾衰竭患者比维生素D更好的选择?

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Denosumab has been proven to be at least as effective with respect to zoledronic acid in preventing skeletal-related events in patients with bone metastases from solid tumors. Although denosumab can be considered to have a more favorable toxicity profile compared to zoledronic acid in terms of kidney toxicity and flu-like symptoms, hypocalcemia is twice as frequent with denosumab. Importantly, denosumab is not metabolized by the kidney and it may be employed even in patients with severe kidney failure. Like zoledronic acid, denosumab is administered with oral calcium and vitamin D. As conversion of vitamin D to its active form is progressively impaired with a creatinine clearance < 70 ml/min, we speculate that calcitriol may be a better option than vitamin D in denosumab-treated patients with impaired kidney function.
机译:事实证明,地诺单抗对于预防实体瘤骨转移患者的骨骼相关事件,至少与唑来膦酸同样有效。尽管就肾脏毒性和流感样症状而言,地诺单抗相比唑来膦酸可以被认为具有更有利的毒性,但地塞单抗的低钙血症发生率是两倍。重要的是,狄诺塞麦不被肾脏代谢,即使在患有严重肾功能衰竭的患者中也可以使用。与唑来膦酸一样,地诺单抗也可以口服钙和维生素D。随着维生素D向其活性形式的转化逐渐受到损害,肌酐清除率<70 ml / min,我们推测钙三醇可能比地诺单抗中的维生素D更好。治疗的肾功能受损的患者。

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