Clin Osteol 2012; 17(3): 84-89

Renal function in IV bisphosphonate therapy in common practiceReview articles

Bubeníček P., Kasalický P., Rosa J.

Background: Treatment of osteoporosis with bisphosphonates is limited by the level of renal function. The study aimed at determi­ ning the levels of renal function in patients of our center for bone disease in common practice prior to and after IV bisphosphonate therapy, and whether the therapy is associated with decreased renal function.

Patients and methods: The study comprised a total of 222 patients (91 % being females; mean age 68 years) receiving IV bisphos­ phonate therapy in a common bone disease center. The group consisted of 95 patients receiving 1-year zoledronate infusions and 127 patients in whom IV ibandronate therapy had been initiated. To assess the level of renal function, the CKD classification was used ba­ sed on calculating estimated glomerular filtration rate (eGFR) with the MDRD equation.

Results: Prior to administration of zoledronate infusions, the mean eGFR was 1.09 ± 0.23 mL/s, with eGFR > 1.0 mL/s in 60.4 % of patients and eGFR < 1.0 mL/s (grade 3 CKD) in 39.6 % of patients; no patient had eGFR < 0.5 mL/s (grades 4 and 5 CKD). The me­ an eGFR after 3 months and 1 year were 1.18 ± 0.23 mL/s and 1.23 ± 0.36 mL/s, respectively. Grade 3 CKD was observed in 27.7 % and 26.9 % of the patients after 3 months and 1 year, respectively. In only 5 patients, classification was changed from grade 2 to grade 3 CKD. In the group of patients treated with IV ibandronate, the mean eGFR prior to therapy was 1.08 ± 0.28 mL/s, with eGFR > 1.0 mL/s in 60.5 % of patients and eGFR < 1.0 mL/s (grade 3 CKD) in 39.5 % of patients; no patient had eGFR < 0.5 mL/s (grades 4 and 5 CKD). The mean eGFR after 3 months and 1 year were 1.09 ± 0.25 mL/s and 1.03 ± 0.24 mL/s, respectively. Grade 3 CKD was ob­ served in 35 % and 4 de 2 to grade 3 CKD.

Conclusion: Patients receiving IV bisphosphonate therapy with ibandronate and zoledronate in a common bone disease center were not found to have clinically significant renal function impairment. There was no difference in the presence of renal complications be­ tween IV ibandronate and zoledronate. Renal function levels do not represent a problem in t clinical practice.

Keywords: chronic kidney disease, renalfunction, bisphosphonates, treatment of osteoporosis

Published: December 11, 2012  Show citation