Related Experiment Video
Updated: May 14, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Risk factors for renal impairment in patients with solid tumors or multiple myeloma treated with zoledronic acid
1Graduate School of Clinical Pharmacy, Sookmyung Women's University, Seoul, Korea.
Objective:
Using retrospective prescription analysis, this study aimed to investigate the risk factors for renal impairment among adult solid tumor and multiple myeloma patients who have received zoledronic acid injections in a teaching hospital over the last 4 years.
Methods:
We examined solid tumor and multiple myeloma patients who had received at least 1 zoledronic acid injection in a teaching hospital in Seoul with at least 2,000 beds over the 4 years between January 2008 and December 2011. The injection histories and serum creatinine levels of these patients were included in the analysis. Patients who developed renal impairment subsequent to zoledronic acid injection were identified, and the risk factors were statistically analyzed.
Results:
In only 1 case was zoledronic acid injection reduced as directed by the creatinine clearance guidelines. Four patients whose creatinine clearance was less than 30 ml/min were injected with zoledronic acid even though its use is contraindicated in this situation. Of the 338 research subjects, 26 developed renal impairment. The following were confirmed to be statistically significant (p < 0.05) risk factors for the development of renal impairment: serum creatinine (at first injection) of greater than 1.4 mg/dl, diabetes, hypertension, thalidomide prescription, multiple myeloma, and previous pamidronate usage.
Conclusions:
Based on the results of this study, renal monitoring is necessary following zoledronic acid injection. In addition, for patients with renal impairment risk factors, a risk-benefit analysis must be performed before zoledronic acid is administered, and it must be administered at an appropriate dose according to the level of renal function.
Insights
Zoledronic acid (ZA) use in cancer patients can lead to renal impairment. Key risk factors include pre-existing diabetes, hypertension, and prior pamidronate use, necessitating careful patient monitoring and dose adjustment.
Area of Science:
- Oncology
- Nephrology
- Pharmacovigilance
Background:
- Zoledronic acid is commonly used for bone metastases in solid tumors and multiple myeloma.
- Renal impairment is a potential adverse effect of zoledronic acid therapy.
- Identifying risk factors is crucial for safe administration.
Purpose of the Study:
- To investigate risk factors for renal impairment in adult solid tumor and multiple myeloma patients receiving zoledronic acid.
- To analyze prescription patterns and patient outcomes in a teaching hospital setting.
Main Methods:
- Retrospective analysis of prescription data and serum creatinine levels.
- Inclusion of adult patients with solid tumors or multiple myeloma who received zoledronic acid over a 4-year period.
- Statistical analysis to identify significant risk factors for renal impairment.
Main Results:
- Twenty-six out of 338 patients developed renal impairment.
- Significant risk factors identified: serum creatinine > 1.4 mg/dl, diabetes, hypertension, thalidomide, multiple myeloma, and prior pamidronate use.
- Suboptimal adherence to creatinine clearance guidelines was observed, with contraindications ignored in some cases.
Conclusions:
- Renal monitoring is essential post-zoledronic acid administration.
- Risk-benefit assessment and dose adjustment based on renal function are critical for high-risk patients.
- Improved adherence to guidelines is needed to mitigate renal complications.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
01:24Chronic Kidney Disease II: Clinical Manifestations
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion