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Denosumab for treatment of immobilization-related hypercalcemia in a patient with end-stage renal disease

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Abstract

The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection. After admission, the patient’s corrected serum calcium rose to 12.9 from 8.8 mg/dL. A bisphosphonate (alendronate) was administered, but it was ineffective. Subsequently, treatment with denosumab proved to be effective and his corrected serum calcium level declined to 9.3 mg/dL within 1 week. Hypocalcemia, which is an adverse effect of denosumab, was prevented using active vitamin D and calcium supplementation, and his calcium level stabilized. Thus, our case demonstrates that denosumab is a viable therapeutic option for dialysis patients experiencing immobilization-related hypercalcemia.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki-shi, Kanagawa, 216-8511, Japan

    Atsuko Uehara, Masahiko Yazawa, Atsumi Kawata, Rina Hachisuka & Yugo Shibagaki

Authors
  1. Atsuko Uehara
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  2. Masahiko Yazawa
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  3. Atsumi Kawata
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  4. Rina Hachisuka
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  5. Yugo Shibagaki
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Correspondence to Atsuko Uehara.

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All the authors have declared no competing interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from the patient in the case report.

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Uehara, A., Yazawa, M., Kawata, A. et al. Denosumab for treatment of immobilization-related hypercalcemia in a patient with end-stage renal disease. CEN Case Rep 6, 111–114 (2017). https://doi.org/10.1007/s13730-017-0254-5

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  • DOI: https://doi.org/10.1007/s13730-017-0254-5

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