SEMINAR: Calcium for Chronic Kidney Disease - Too much of a good thing

Dr Sophie Jamal is a scientist at Women's College Research Institute, and a clinician with the Multidisciplinary Osteoporosis Care Team at Women's College Hospital. She chairs the Women's College Hospital department of medicine research committee, and she is an associate professor in the Department of Medicine (division of endocrinology and metabolism) and Institute of Health Policy, Management & Evaluation at the University of Toronto.

As a scientist, Dr Jamal studies novel treatments for osteoporosis, a common, debilitating and preventable condition that often afflicts older people, especially women. Currently, Dr Jamal is the recipient of funding from the Canadian Institutes of Health Research to determine the effects of organic nitrates to prevent bone loss in postmenopausal women. Organic nitrates, such as nitroglycerine, are currently used to treat heart conditions like angina. They are available worldwide, and they are inexpensive and safe for long-term use. Dr Jamal has demonstrated that women who take nitrates for angina have higher bone mineral density compared with non-users. In addition, she has found that healthy women who take nitrates have a decrease in bone breakdown and an increase in bone formation compared to non-users. Unlike currently prescribed medications for osteoporosis, nitric oxide appears to both a reduce bone loss and increase in bone formation.

In addition, Dr Jamal examines ways to manage bone disease in patients with complex medical illnesses such as chronic kidney disease. She has demonstrated that men and women with kidney disease are at dramatically increased risk of fracture and the increase in fracture risk often occurs before the start of dialysis. She is now undertaking a multi-centre study to comprehensively assess risk factors for fracture and potential treatments in these patients.