Chronic Kidney Disease

IV Therapy for Osteoporosis: Evenity and Prolia

Osteoporosis is a chronic condition characterized by weakened bones, increasing the risk of fractures and other complications. As the population ages, the prevalence of osteoporosis is expected to rise, making effective treatment strategies critical. While oral bisphosphonates have been the mainstay of osteoporosis treatment, intravenous (IV) therapy has emerged as an important alternative, particularly for patients who may not tolerate oral medications or have more severe disease. Among the various treatment options available, two notable drugs are Evenity (romosozumab) and Prolia (denosumab), both of which are administered via injection and have shown promising results in improving bone density and reducing fracture risk.

Understanding Osteoporosis and Its Impact

Osteoporosis occurs when the balance between bone resorption and bone formation is disrupted, leading to a net loss of bone mass. This condition can result from various factors, including hormonal changes (such as decreased estrogen in postmenopausal women), nutritional deficiencies (like low calcium and vitamin D levels), and certain medications or medical conditions. The consequences of osteoporosis can be severe, as fragility fractures, particularly of the hip, spine, and wrist, can significantly impact quality of life and increase morbidity and mortality.

IV Therapy as a Treatment Option

While many osteoporosis treatments are available in oral form, IV therapy provides an essential alternative, especially for patients with gastrointestinal issues, those who have difficulty adhering to daily or weekly oral regimens, or individuals with a high fracture risk. IV therapies allow for direct delivery of medication into the bloodstream, ensuring rapid absorption and effectiveness. Among the newer IV therapies, Evenity and Prolia have gained attention for their unique mechanisms of action and clinical efficacy.

Evenity (Romosozumab)

Evenity is a monoclonal antibody that works by targeting sclerostin, a protein that inhibits bone formation. By blocking sclerostin, Evenity stimulates osteoblast activity, promoting new bone formation while also reducing bone resorption. This dual action leads to a significant increase in bone mineral density and a reduction in fracture risk.

Administered as a monthly injection, Evenity is particularly beneficial for postmenopausal women with a high risk of fracture, especially those who have experienced prior fractures. Clinical trials have demonstrated that Evenity significantly reduces the risk of vertebral and nonvertebral fractures. However, treatment with Evenity is typically limited to 12 months, after which patients are often transitioned to other osteoporosis therapies to maintain bone density gains.

Prolia (Denosumab)

Prolia is another monoclonal antibody that targets RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand), a key factor in the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. By inhibiting RANKL, Prolia effectively reduces bone resorption and turnover, leading to increased bone mass and strength.

Prolia is administered as a biannual injection and is indicated for both men and women at high risk of fracture. It has shown efficacy in reducing the incidence of vertebral, hip, and nonvertebral fractures in clinical studies. Unlike Evenity, Prolia is not limited to a specific duration of treatment; however, if the treatment is stopped, there is a risk of rebound fractures due to increased bone resorption.

Considerations and Side Effects

Both Evenity and Prolia have specific considerations regarding their use. Common side effects may include injection site reactions, musculoskeletal pain, and a potential increased risk of infections with Prolia due to its immunosuppressive effects. Additionally, Evenity has been associated with cardiovascular risks, necessitating careful patient selection and monitoring.

Before initiating IV therapy, healthcare providers should conduct a thorough assessment of the patient’s fracture risk, medical history, and any contraindications to ensure optimal treatment outcomes. Regular follow-up and monitoring are essential to assess bone density and adjust treatment as necessary.

Convenient Infusion Options with PRINE Infusion

Patients seeking IV therapy for osteoporosis now have convenient access to Evenity and Prolia at PRINE Infusion, which has three locations in Plainview, Garden City, and Bellmore, NY. This accessibility makes it easier for patients to receive the necessary treatments in a comfortable and supportive environment, ensuring they can stay on track with their osteoporosis management. Contact us at 516-408-1900.

Conclusion

IV therapy represents a vital option in the management of osteoporosis, particularly for patients at high risk of fracture who cannot tolerate oral medications. Evenity and Prolia are two innovative treatments that offer significant benefits in improving bone density and reducing fracture risk. As the understanding of osteoporosis evolves and more therapies become available, a personalized approach to treatment will be crucial in managing this pervasive condition and improving the quality of life for those affected. By combining effective medical therapies with lifestyle modifications, patients can take proactive steps toward maintaining their bone health and reducing their risk of fractures.

What Are the Best Dietary Options for Someone Dealing with Kidney Disease?

When facing kidney disease, it’s essential to know that you will need to make changes in your diet. You will need to work with your doctor to create a plan. Always remember to consult with your doctor about the best dietary options when dealing with kidney disease, and follow best practices to stay as healthy as possible.

Let’s look at what foods are good or bad, and why?

Some of the Best Dietary Options for Dealing with Kidney Disease

  • Garlic
  • Onions
  • Apples
  • Cranberries
  • Blueberries
  • Red Bell Peppers
  • Cauliflower
  • Cabbage
  • Raspberries
  • Strawberries
  • Cherries
  • Red Grapes
  • Egg Whites
  • Fish
  • Olive Oil
  • Italian, French, or sourdough bread
  • Corn or rice cereals (Cream of Wheat)
  • Herbs and spices instead of salt

Some of the Worse Dietary Options for Dealing with Kidney Disease

  1. Processed meat such as ham, bacon, sausage, and lunch meat
  2. Pickled foods such as olives and pickles
  3. Whole grain bread
  4. Bran cereals and oatmeal
  5. Nuts and sunflower seed
  6. Dark-colored colas
  7. Very high-protein diets

When Kidneys are damaged, one may not want to consume as much liquid because the kidneys may not expel extra fluid as they normally would. Fluid building up in the body can lead to high blood pressure, painful swelling, and even heart failure. It’s especially important to avoid sodium to reduce thirst. If the nutria label says an item has 20% or more sodium, it is considered high in sodium. The item should be avoided.  Seek to eat foods that have moderate levels of protein and very low sodium. Be aware of your fluid intake and choices.

Food choices are important, but even more so, you should know what liquids to avoid, such as:

  • Coffee: This can dehydrate you, and it is difficult for the kidney to filter.
  • Soups: These typically are very high in sodium.
  • Foods that melt, like ice, ice cream, and gelatin: While Jell-O and ice cream may not be seen as a liquid, they dissolve into liquid and are also high in sugar.
  • Alcohol: Any intake of alcohol is detrimental to the kidneys. Alcohol is generally full of sugar, which is very bad for people suffering from kidney disease.

Of course, there will be times when you might have to be at a function where alcohol and other foods are being served. In those cases, opt for light-colored sodas like 7-up or Sprite. When possible, choose water, of course. You won’t be able to tell what items are good or bad for you or are full of salt or sugar. Party, food doesn’t come with a label but suffice to say, eat lightly, bite cake rather than an entire piece, make a small plate, and taste rather than binge.

If you are in stage 1 or 2 and even stage 3, you might not feel some of the effects of the food you are eating all the time. The sooner you get on top of things, the longer you can stave off digression and extensive damage. The more you abuse your kidneys with poor food choices, the more they head toward failure.

Vitamins:
To combat the possible side effects of kidney disease such as bone disease and anemia, consuming a proper amount of vitamin D, folic acid, and iron is suggested. Beware of the general multi-vitamin which may not be suitable for you. You may consider PRINE Health’s nephrology formulated, PRINE VITE Complete. As always, consult with your doctor.

Fast Food:

Generally speaking, fast food is often a very poor choice for someone facing renal failure. In fact, fast food is usually not suitable for any diet. The products produced at fast-food restaurants are loaded with salt and sugar, as well as bad fats. These products are processed foods, and your best bet is to eat organic, low salt, and good fats as opposed to something created in a factory.

The Rules of Protein:

When a person eats protein, the body creates waste that the kidneys have to filter through.
You need protein in your diet, but if your kidneys are damaged, you will have to be careful to eat. Typically, lower protein diets are protective for your kidneys.

There are two kinds of protein – plant-based and animal-based.

Animal-Protein Options:

  1. Fish
  2. Eggs
  3. Dairy
  4. Chicken
  5. Turkey
  6. Beef

Planet-Based Protein Options:

  1. Lentils
  2. Beans
  3. Nuts
  4. Quinoa
  5. Chickpeas

In general, the main thing is to work with your doctors, both your general practitioner and your specialists, to create a diet you can live with that will give you both the best quality of life and the best kidney health possible.

No one wants to be restricted in their diet. It’s not fun. We all have our favorite foods. For some, it’s pizza and burgers, for others, cake, and ice cream. Within reason, you can have small treats to take the edge off the restricted diet you may need to follow. Still, a solid plan for healthy kidney food will be an essential element of your treatment and overall well-being.

If you seek advice from experts on the best dietary options for Kidney disease or for any questions related to Kidney Disease, please reach out to us at PRINE Health. We have kidney specialists and clinical nutritionists who can work together to create the best path for your future kidney health.

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