In Kidney Disease Marriage, Raloxifene Wears the Pants

The osteoporosis drug raloxifene may be useful in treating kidney disease in women, suggests a new study led by Michal Melamed, MD, MHS, assistant professor of medicine and epidemiology & population health at the Albert Einstein College of Medicine of Yeshiva University.

According to government statistics, an estimated 23 million American adults over age 20 suffers from chronic kidney disease%u2015more than one out of 10. More than a half-million patients are under treatment for end-stage renal disease. New treatments are urgently needed.

In the study, published in Kidney International, Dr. Melamed and Sharon Silbiger, MD, professor of clinical medicine and associate chair for undergraduate medical education at Einstein, looked at data from the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, a study of 7,705 post-menopausal women with osteoporosis conducted from 1994 to 1999.

The women were randomly assigned to take either 60 or 120 mg of raloxifene (Evista) per day or a placebo, and were given a blood test yearly to assess kidney function.

After three years, women taking raloxifene had less of a decline in kidney function than women taking a placebo. More specifically, compared with women in the placebo group, women on the 60 mg raloxifene dose had a statistically significant slower yearly rate of increase in the blood creatinine level, high levels of which are an indicator of poor kidney function.

Women on both doses of raloxifene experienced a statistically significant slowing in the decrease of their glomerular filtration rate (GFR).

GFR naturally declines with age. A significant decline can be an early indicator of kidney disease that requires intervention. Physicians are looking for medications that slow the decline in GFR, and this study shows that raloxifene may have this effect.

“There are few treatments for kidney disease, so if further studies confirm these findings, raloxifene potentially could be widely used as another treatment. What's needed now is a rigorous study on raloxifene in women with advanced kidney disease,” Dr. Melamed said. She noted that because raloxifene works on estrogen receptors, the drug might cause side effects if given to men.