Role of Denosumab in Chronic Kidney Disease with Paget's Disease of Bone: A Case Report and Review of Literature
Abstract
Introduction: Paget's disease of bone (PDB) is rarely encountered in patients with chronic kidney disease (CKD), with limited reports in the literature. The coexistence of these conditions poses significant diagnostic and therapeutic challenges. This case report examines the management of PDB in advanced CKD, where standard bisphosphonate therapy is contraindicated.
Case report: We report a 51-year-old male with CKD stage 5 presenting with bone pain, deformity, and fracture. Imaging and biochemical evaluation confirmed the diagnosis of Paget's disease. Due to contraindications to bisphosphonates, the patient was treated with denosumab. The patient showed initial symptomatic and biochemical improvement; however, recurred after 4 months, requiring repeated doses.
Conclusion: This case suggests that denosumab could be an alternative in advanced CKD with PDB where bisphosphonates are contraindicated. However, clinicians should be aware of limitations such as the paucity of evidence, the potential for recurrence, and the need for careful monitoring of hypocalcemia. Further research is needed to establish long-term safety and efficacy of denosumab in these patients.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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