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Nephrotic syndrome induced by pamidronate
M A G J ten Dam1, L B Hilbrands, J F M Wetzels
1Department of Internal Medicine, Canisius Wilhelmina Hospital, P.O. Box 9015, 6500, Nijmegen, The Netherlands. m.t.dam@cwz.nl
Medical Oncology (Northwood, London, England)
|September 25, 2010
Summary
Intravenous pamidronate can cause nephrotic syndrome and kidney damage, specifically collapsing focal segmental glomerulosclerosis (FSGS). Monitoring kidney function is crucial during bisphosphonate therapy, especially in patients with pre-existing kidney issues.
Area of Science:
- Nephrology
- Pharmacology
- Pathology
Background:
- Bisphosphonates, particularly intravenous pamidronate, are widely used for bone-related conditions.
- Potential renal toxicity associated with bisphosphonate therapy requires careful consideration.
Observation:
- Two patients receiving intravenous pamidronate developed nephrotic syndrome and declining renal function.
- Renal biopsies in both patients revealed collapsing focal segmental glomerulosclerosis (FSGS).
Findings:
- Discontinuation of pamidronate led to recovery in one patient, while the other required dialysis.
- The study highlights collapsing FSGS as a serious complication of pamidronate treatment.
Implications:
- Regular monitoring of urinary protein excretion and renal function is essential for patients on long-term intravenous bisphosphonates.
- Caution is advised when administering bisphosphonates to patients with estimated GFR below 30 ml/min due to increased risk of nephrotoxicity.
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