[Prevention of glucocorticoid-induced osteoporosis in patients with primary glomerulonephritis]

To investigate the changes of bone metabolism in patients with primary glomerulonephritis who receive glucocorticoid (GC) treatment and to compare the therapeutic efficacy and security of alfacalcidol in prevention of glucocorticoid-induced osteoporosis (GIOP).

89 patients with primary glomerulonephritis, aged 18 approximately 50, were randomly divided into 3 groups: Group A (n = 30) treated with alfacidol 1.0 microg/d plus calcium carbonate 750 mg Tid, Group B (n = 30) treated with alfacidol 0.5 microg/d plus calcium carbonate 750 mg Tid, and control group (n = 29) treated with calcium carbonate 750 mg Tid. The bone mineral density (BMD) at the lumbar spine and femoral neck was measured, and the serum levels of osteocalcin (OC), calcium, phosphorus, albumin (Alb), and creatine (Scr) were examined before and 3, 6, and 12 months after the treatment.

The values of BMD at the lumbar spine and femoral neck before the treatment was not significantly different from those 3, 6, and 12 months after the treatment in Groups A and B (all P > 0.05) and there were no significant differences in the BMD values at different time points between Group A and Group B. In the control group the BMD values at the lumbar spine 3, 6, and 12 months after the beginning of experiment were significantly lower than that before the experiment and significantly lower than the corresponding values of Groups A and B (all P < 0.05), however, there was no significant difference in the BMD value at the femoral neck before and after the experiment in the control group. The serum OC 3, 6, and 12 months after were significantly lower than that before the experiment (all P < 0.05) in the control group. However, there was no significant difference in the value of serum OC before and 3, 6, and 12 months after the treatment in Groups A and B (all P > 0.05).

Treatment of alfacidol 0.5 microg/d plus calcium carbonate helps preserve the BMD and prevent bone loss in the patients with primary glomerulonephritis.