Skip to main content

Advertisement

SpringerLink
Log in

Effect of intravenous hydration in patients receiving bisphosphonate therapy

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Patients with advanced cancers are at high risk for bone metastases, which accelerate bone resorption and skeletal complications. Therefore, bisphosphonates, which are strong inhibitors of bone resorption, are widely used to prevent pathological fractures, pain and tumour-induced hypercalcaemia. Intravenous infusion of bisphosphonate is associated with dose- and infusion rate-dependent adverse renal effects. Objective The present study investigated the effect of hydration on bisphosphonate efficacy and safety. Settings The 600-bed CHOV Hospital (Neufchâteau, France) and the Université de Lorraine (Nancy, France). Methods Patients who received pamidronate or zoledronic acid treatments were identified: 50 patients [16 of whom were hydrated and 34 of whom were non-hydrated]. Data on serum calcium levels, creatinine clearance and clinical tolerance were collected. Main outcome measure The impact of hydration on these parameters was analysed between day 1 and day 7. Results Bisphosphonate normalized calcaemia and hydration did not induce further reduction of calcium levels. Patient kidneys were significantly preserved by hydration in both groups (median clearance: +6.2 %), whereas dehydrated patients had lower creatinine clearance (median clearance: −1.1 %). Hydration did not influence other clinical or biological parameters tested. Conclusion Hydration plays an important role in the treatment of hypercalcaemia by pamidronate and zoledronic acid: it enhances kidney protection (i.e., creatinine clearance).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Stewart A. Hypercalcemia associated with cancer. N Engl J Med. 2005;352:373–9.

    Article  CAS  PubMed  Google Scholar 

  2. U.S. Food and Drug Administration. Zoledronic acid for osteoporosis (marketed as reclast). In: FDA editor. Drug safety newsletter, vol 2(2). Silver Spring: FDA; 2009. p. 16–8.

  3. Actonel®—Prescribing information. 2013. http://www.actonel.com/global/prescribing_information.pdf. Accessed 10 April 2014.

  4. Boniva®—Prescribing information. 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021455s009lbl.pdf. Accessed 10 April 2014.

  5. Fosamax®—Prescribing information. 2013. http://www.merck.com/product/usa/pi_circulars/f/fosamax/fosamax_pi.pdf. Accessed 10 April 2014.

  6. Reclast®—Prescribing information. 2013. http://www.pharma.us.novartis.com/product/pi/pdf/reclast.pdf. Accessed 10 April 2014.

  7. Markowitz GS, Appel GB, Fine PL, Fenves AZ, Loon NR, Jagannath S, et al. Collapsing focal segmental glomerulosclerosis following treatment with high dose pamidronate. J Am Soc Nephrol. 2001;12:1164–72.

    CAS  PubMed  Google Scholar 

  8. Tralongo P, Repetto L, Di Mari A, Mauceri G, Bollina R, Ferrau F, et al. Safety of long-term administration of bisphosphonates in elderly cancer patients. Oncology. 2004;67:112–6.

    Article  CAS  PubMed  Google Scholar 

  9. Ali SM, Esteva FJ, Hortobagyi G, Harvey H, Seaman J, Knight R, et al. Safety and efficacy of bisphosphonates beyond 24 months in cancer patients. J Clin Oncol. 2001;19:3434–7.

    CAS  PubMed  Google Scholar 

  10. Lumachi F, Brunello A, Roma A, Basso U. Cancer-induced hypercalcemia. Anticancer Res. 2009;29:1551–5.

    CAS  PubMed  Google Scholar 

  11. LeGrand SB. Narrative review: furosemide for hypercalcemia: an unproven yet common practice. Ann Intern Med. 2008;149:259–63.

    Article  PubMed  Google Scholar 

  12. Fisken RA, Heath DA, Bold AM. Hypercalcaemia—a hospital survey. QJM-Int J Med. 1980;49:405–18.

    CAS  Google Scholar 

  13. Russell RG, Watts NB, Ebetino FH, Rogers MJ. Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008;19:733–59.

    Article  CAS  PubMed  Google Scholar 

  14. Luhe A, Kunkele KP, Haiker M, Schad K, Zihlmann C, Bauss F, et al. Preclinical evidence for nitrogen-containing bisphosphonate inhibition of farnesyl diphosphate (FPP) synthase in the kidney: implications for renal safety. Toxicol In Vitro. 2008;22:899–909.

    Article  CAS  PubMed  Google Scholar 

  15. Bounameaux HM, Schifferli J, Montani JP, Jung A, Chatelanat F. Renal failure associated with intravenous diphosphonates. Lancet. 1983;1:471.

    Article  CAS  PubMed  Google Scholar 

  16. Fleisch H. Bisphosphonates: mechanisms of action. Endocr Rev. 1998;19:80–100.

    Article  CAS  PubMed  Google Scholar 

  17. Green JR, Seltenmeyer Y, Jaeggi KA, Widler L. Renal tolerability profile of novel, potent bisphosphonates in two short-term rat models. Pharmacol Toxicol. 1997;80:225–30.

    Article  CAS  PubMed  Google Scholar 

  18. Markowitz GS, Fine PL, Stack JI, Kunis CL, Radhakrishnan J, Palecki W, et al. Toxic acute tubular necrosis following treatment with zoledronate (Zometa). Kidney Int. 2003;64:281–9.

    Article  CAS  PubMed  Google Scholar 

  19. Bodmer M, Amico P, Mihatsch MJ, Haschke M, Kummer O, Krahenbuhl S, et al. Focal segmental glomerulosclerosis associated with long-term treatment with zoledronate in a myeloma patient. Nephrol Dial Transplant. 2007;22:2366–70.

    Article  PubMed  Google Scholar 

  20. Henley D, Kaye J, Walsh J, Cull G. Symptomatic hypocalcaemia and renal impairment associated with bisphosphonate treatment in patients with multiple myeloma. Intern Med J. 2005;35:726–8.

    Article  CAS  PubMed  Google Scholar 

  21. Solomon R, Werner C, Mann D, D’Elia J, Silva P. Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. N Engl J Med. 1994;331:1416–20.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all physicians and nurses who helped us for this study.

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. CHOV, Site de Neufchâteau, Pharmacie, 1280, Avenue de la Division Leclerc, 88300, Neufchâteau, France

    David Attivi, Gaétan Kosmalski, Claire Zeghmouli & Stéphane Gibaud

  2. Faculté de Pharmacie, Equipe CITHEFOR (EA3452), Université de Lorraine, 5, rue Albert Lebrun, 54000, Nancy, France

    Stéphane Gibaud

  3. Faculté de Pharmacie, Pharmacie Clinique, Université de Lorraine, 5, rue Albert Lebrun, 54000, Nancy, France

    Stéphane Gibaud

Authors
  1. David Attivi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gaétan Kosmalski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claire Zeghmouli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stéphane Gibaud
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stéphane Gibaud.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Attivi, D., Kosmalski, G., Zeghmouli, C. et al. Effect of intravenous hydration in patients receiving bisphosphonate therapy. Int J Clin Pharm 36, 1277–1281 (2014). https://doi.org/10.1007/s11096-014-9994-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-014-9994-x

Keywords

Search

Navigation