Fanconi Syndrome After a Single Exposure to Intravenous Zoledronic Acid

Area of Science:

• Nephrology
• Pharmacology
• Endocrinology

Background:

• Bisphosphonates, including Zoledronic acid, are standard treatments for osteoporosis and bone-related complications.
• Nephrotoxicity is a known, though infrequent, complication of Zoledronic acid therapy.
• Fanconi syndrome is a rare renal tubular disorder.

Purpose of the Study:

• To report a case of Fanconi syndrome following a single intravenous dose of Zoledronic acid in a patient with normal renal function.
• To review the literature on Zoledronic acid-induced nephrotoxicity and Fanconi syndrome.
• To emphasize the potential for Zoledronic acid to cause severe renal adverse events even in patients without pre-existing kidney disease.

Main Methods:

• Case report of an elderly female patient.
• Literature review of Zoledronic acid-related nephrotoxicity and Fanconi syndrome.
• Analysis of patient's renal function before and after Zoledronic acid administration.

Main Results:

• The patient developed Fanconi syndrome after a single dose of intravenous Zoledronic acid, despite normal baseline renal function.
• Literature search revealed existing cases of Fanconi syndrome associated with Zoledronic acid, primarily in patients with malignancy.
• This case represents one of the first instances of Fanconi syndrome after a single Zoledronic acid exposure in a patient with normal renal function.

Conclusions:

• Zoledronic acid can induce significant nephrotoxicity, including Fanconi syndrome, even after a single administration in patients with normal renal function.
• Awareness of this potential adverse effect is crucial for clinicians, especially when prescribing Zoledronic acid for osteoporosis.
• Further investigation into the mechanisms and risk factors for Zoledronic acid-induced Fanconi syndrome is warranted.