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Abstract: SA-PO698

Trends in Serum Parameters Levels According to Renal Function Following Denosumab

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical


  • Lee, Jin Hyeog, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Osteoporosis and chronic kidney disease (CKD) are major risk factors for fracture. Denosumab is widely used to treat osteopenia in patients with CKD; however, its effect on phosphate, calcium, and parathyroid hormone (PTH) levels has not been fully elucidated.


A retrospective observational study was performed on patients from three hospitals in Korea who were treated with denosumab between November 2016 and December 2021. We compared the mean percentage change in serum phosphate, calcium, and PTH levels from baseline to six months post-denosumab treatment. Among the 11 586 patients (median age, 70.0 years; 89.2% female) included in this study, 10 069 (87.9%) had an estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73 m2 and comprised the preserved kidney function group. Patients with an eGFR under 60 mL/min/1.73 m2 (n = 1 517) comprised the reduced kidney function group.


One month after denosumab administration, serum calcium (preserved kidney function group: -3.18%; reduced kidney function group: -6.35%) and phosphate levels (preserved group: -10.9%; reduced group: -9.56%) decreased and serum PTH levels increased (preserved group: +123.54%; reduced group: +216.93%). However, all parameters returned to baseline six months after treatment. Six months after denosumab treatment, a higher rate of hypocalcaemia was observed in the reduced kidney function group relative to that of the preserved kidney function group (4.5 and 8.3%, respectively, p < 0.001).


One month post-denosumab treatment, serum phosphate and calcium levels significantly decreased and PTH levels increased; however, these changes were transient. When using denosumab in reduced kidney function patients, close monitoring and replacement of calcium and vitamin D are required.

Hypocalcemia at baseline and 6 months after denosumab treatment
 OverallReduced kidney function group (%)Preserved kidney function group (%)P-value
N=11,586 (100.0)N=1,517 (13.1)N=10,069 (86.9)
At baseline883 (9.1)137 (10.4)746 (8.9)0.091
At 6 months after denosumab treatment287 (5.0)67 (8.3)220 (4.5)<0.001