{"id":"b43383e82185","type":"article","url":"https://hartvaat.nl/2026/09/25/denosumab-beinvloedt-vaatcalcificatie-niet-bij-dialysepatienten-meta-analyse/","title":"Denosumab beïnvloedt vaatcalcificatie niet bij dialysepatiënten — meta-analyse","title_en":"Effects of denosumab or romosozumab on vascular calcification in dialysis patients: a systematic review and meta-analysis.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Kidney & blood pressure research","doi":"10.1159/kbr/adjag010","source_url":"https://doi.org/10.1159/kbr/adjag010","authors":["Dueanchonnee Sribenjalak","Hyeonmok Kim","Peter R Ebeling","Alexander J Rodríguez"],"significance":5,"published":"2026-10-03","source_date":"2026-09-25","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"A systematic review and meta-analysis evaluated the impact of denosumab and romosozumab on vascular calcification in hemodialysis patients. Analysis of six studies (422 participants) on denosumab showed no significant effect on vascular calcification (SMD -0.20; 95% CI -0.75 to 0.36), whereas a single romosumab study reported an increase in calcium scores. All included studies noted post-injection hypocalcemia. These findings suggest denosumab is likely safe regarding vascular calcification in dialysis patients, but romosozumab warrants caution, and serum calcium should be closely monitored when using either agent.","created":"2026-09-26T01:13:54Z","updated":"2026-09-26T01:13:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een systematische review en meta-analyse onderzocht het effect van denosumab en romosozumab op vaatcalcificatie bij hemodialysepatiënten. Bij denosumab (6 studies, 422 patiënten) werd geen significant verschil in vaatcalcificatie gevonden (SMD -0,20; 95% BI -0,75 tot 0,36), terwijl één studie met romosozumab een toename in calciumscore rapporteerde. Alle studies meldden postinjectie-hypocalcemia. Voor de klinische praktijk betekent dit dat denosumab waarschijnlijk veilig is wat betreft vaatcalcificatie, maar dat romosozumab met voorzichtigheid moet worden gebruikt en de serumcalciumspiegel nauwlettend in de gaten gehouden moet worden.","abstract_original":"INTRODUCTION: Patients on hemodialysis are at high risk of vascular calcification, which contributes to cardiovascular events and mortality. The impact of osteoporosis therapies, including denosumab and romosozumab, on vascular calcification in this population remains uncertain. This systematic review and meta-analysis aim to synthesize current evidence on their effects, addressing a critical knowledge gap in advanced chronic kidney disease (CKD) management. METHODS: MEDLINE, Embase, and Web of Science were searched through November 2025 for studies evaluating either denosumab or romosozumab and vascular calcification in hemodialysis patients. Random-effects models were used to pool standardized mean differences (SMDs) with 95% confidence intervals, and leave-one-out sensitivity analyses assessed robustness. RESULTS: Six studies on denosumab and one on romosozumab were included. Meta-analysis of denosumab (422 participants) showed a small, non-significant change in vascular calcification (SMD -0.20 95% CI -0.75 to 0.36; I² = 82.6%). Subgroup analysis of coronary artery calcification yielded similar non-significant results (SMD -0.22, 95% CI -0.67 to 0.23; I² = 41.5%). The single romosozumab study reported a significant increase in calcium score from baseline. All studies reported post-injection hypocalcemia. CONCLUSION: Current evidence indicates that denosumab does not significantly alter vascular calcification in dialysis patients, whereas limited data suggest romosozumab may increase vascular calcification. Serum calcium should be monitored in dialysis patients receiving these agents. Given the small number of studies and substantial heterogeneity, further well-designed prospective studies are required to clarify the cardiovascular safety of these agents in advanced CKD."}