TY - JOUR
T1 - An age-related decrease in creatinine clearance is associated with an increase in number of falls in untreated women but not in women receiving calcitriol treatment
AU - Gallagher, J. Christopher
AU - Rapuri, Prema B.
AU - Smith, Lynette M.
N1 - Funding Information:
This work was supported by National Institute of Aging Grants UO1-AG10373 and RO1-AG10358 and Wyeth Pharmaceuticals, Hoffmann-La Roche Inc., and Pfizer (Pharmacia & Upjohn).
Funding Information:
Disclosure Summary: J.C.G. is a consultant for Wyeth Research and Pfizer; he has received research grants from Wyeth Research and Pfizer, equity (shares) in Pfizer, and lecture fees from Wyeth Research and Pfizer. P.B.R. and L.M.S. have nothing to disclose.
PY - 2007/1
Y1 - 2007/1
N2 - Context: Decreased calcitriol production due to impaired renal function may be a significant risk factor for falls in normal aging population. Objective: The objective of the study was to examine the association between creatinine clearance (CrCl) and the incidence of falls and fallers in groups treated with placebo, calcitriol, estrogen therapy (ET)/estrogen + progestin therapy (HT), and calcitriol + ET/HT. Design: This was a 3-yr, double-blind, placebo-controlled study designed to test the efficacy of calcitriol and ET/HT on bone loss and falls with analysis by intention to treat and post hoc. Setting: The study was conducted at an academic outpatient center. Participants: Four hundred eighty-nine normal elderly women aged 65-77 yr; 415 women completed the study. Intervention: Subjects were randomized to placebo, calcitriol 0.25 μg twice a day, ET daily (conjugated equine estrogens 0.625 mg), HT (conjugated equine estrogen 0.625 mg + medroxyprogesterone acetate 2.5 mg) and calcitriol + ET/HT. Main Outcome Measures: Cumulative number of falls and fallers were compared between groups with 24-h urine CrCl less than 60 and 60 ml/min or greater. Results: Calcitriol treatment decreased the number of fallers and falls. Low CrCl less than 60 ml/min was a predictor of the number of falls per person but not fallers in the placebo group (P = 0.007). In the low CrCl group (<60 ml/min), the rate of falls decreased on calcitriol by 53% [95% confidence interval (CI) -71% to -22%; P = 0.003], calcitriol + ET/HT by 61% (95% CI -76% to -37%; P = 0.001), and ET/HT by 25% (95% CI: -55% to +24%; not significant). Calcitriol reduced the rate of falls by 30% (95% CI -49% to -4%; P = 0.027) in the CrCl 60 ml/min or greater group. Conclusion: Calcitriol treatment decreases falls in all subjects but especially in elderly women with decreased renal function (<60 ml/min) and frequent fallers.
AB - Context: Decreased calcitriol production due to impaired renal function may be a significant risk factor for falls in normal aging population. Objective: The objective of the study was to examine the association between creatinine clearance (CrCl) and the incidence of falls and fallers in groups treated with placebo, calcitriol, estrogen therapy (ET)/estrogen + progestin therapy (HT), and calcitriol + ET/HT. Design: This was a 3-yr, double-blind, placebo-controlled study designed to test the efficacy of calcitriol and ET/HT on bone loss and falls with analysis by intention to treat and post hoc. Setting: The study was conducted at an academic outpatient center. Participants: Four hundred eighty-nine normal elderly women aged 65-77 yr; 415 women completed the study. Intervention: Subjects were randomized to placebo, calcitriol 0.25 μg twice a day, ET daily (conjugated equine estrogens 0.625 mg), HT (conjugated equine estrogen 0.625 mg + medroxyprogesterone acetate 2.5 mg) and calcitriol + ET/HT. Main Outcome Measures: Cumulative number of falls and fallers were compared between groups with 24-h urine CrCl less than 60 and 60 ml/min or greater. Results: Calcitriol treatment decreased the number of fallers and falls. Low CrCl less than 60 ml/min was a predictor of the number of falls per person but not fallers in the placebo group (P = 0.007). In the low CrCl group (<60 ml/min), the rate of falls decreased on calcitriol by 53% [95% confidence interval (CI) -71% to -22%; P = 0.003], calcitriol + ET/HT by 61% (95% CI -76% to -37%; P = 0.001), and ET/HT by 25% (95% CI: -55% to +24%; not significant). Calcitriol reduced the rate of falls by 30% (95% CI -49% to -4%; P = 0.027) in the CrCl 60 ml/min or greater group. Conclusion: Calcitriol treatment decreases falls in all subjects but especially in elderly women with decreased renal function (<60 ml/min) and frequent fallers.
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U2 - 10.1210/jc.2006-1153
DO - 10.1210/jc.2006-1153
M3 - Article
C2 - 17032712
AN - SCOPUS:33846077677
SN - 0021-972X
VL - 92
SP - 51
EP - 58
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 1
ER -