[Zoledronate-associated end stage renal failure and hypocalcaemia]

Area of Science:

• Nephrology
• Oncology
• Pharmacology

Background:

• Multiple myeloma is a malignancy of plasma cells.
• Bisphosphonates are commonly used to treat myeloma-related bone disease.
• Chronic renal failure is a common comorbidity in multiple myeloma patients.

Observation:

• An 81-year-old patient with chronic renal failure was treated with zoledronic acid for multiple myeloma.
• The patient developed end-stage renal failure after approximately one year of zoledronic acid therapy.
• Renal biopsy revealed severe tubulointerstitial damage consistent with drug-induced tubular injury.

Findings:

• Zoledronic acid was diagnosed as the cause of end-stage renal failure.
• The patient required long-term hemodialysis.
• Severe hypocalcemia was also noted and treated with supplements.

Implications:

• This case underscores the nephrotoxic potential of zoledronic acid.
• Careful renal function monitoring is crucial in patients receiving zoledronic acid, particularly those with pre-existing renal impairment.
• Alternative treatment strategies may be necessary for patients with multiple myeloma and chronic kidney disease.