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Nephrotic syndrome with acute kidney injury due to focal segmental glomerulosclerosis following long-term treatment with minodronate

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Abstract

Although bisphosphonates are well known to cause kidney disease, there are very few published cases of focal segmental glomerulosclerosis (FSGS) following treatment with minodronate. Here we report the case of an 86-year-old woman who developed acute kidney injury and nephrotic syndrome after receiving monthly oral minodronate for 24 months. Kidney biopsy revealed cellular variant FSGS. Treatment was initiated with the discontinuation of minodronate followed by intravenous methylprednisolone pulse and prednisolone at 35 mg/day. Subsequently, the patient’s renal function gradually worsened, requiring initiation of hemodialysis. However, renal function and proteinuria improved markedly and hemodialysis was withdrawn 1 month after the initiation of steroid therapy. This is, to our knowledge, the first published case of FSGS induced by long-term use of minodronate, and also the first case of cellular variant FSGS induced by bisphosphonates although collapsing variant of FSGS is commonly caused by bisphosphonates. Our study indicates that patients on bisphosphonates should be closely monitored for proteinuria and renal impairment, regardless of the type of bisphosphonate.

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References

  1. Ohishi T, Matsuyama Y. Minodronate for the treatment of osteoporosis. Ther Clin Risk Manag. 2018;14:729–39.

    Article  CAS  Google Scholar 

  2. Markowitz GS, Appel GB, Fine PL, Fenves AZ, Loon NR, Jagannath S, Kuhn JA, Dratch AD, D’Agati VD. Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate. J Am Soc Nephrol. 2001;12:1164–72.

    Article  CAS  Google Scholar 

  3. Barri YM, Munshi NC, Sukumalchantra S, Abulezz SR, Bonsib SM, Wallach J, Walker PD. Podocyte injury associated glomerulopathies induced by pamidronate. Kidney Int. 2004;65:634–41.

    Article  Google Scholar 

  4. Desikan R, Veksler Y, Raza S, Stokes B, Sabir T, Li ZJ, Jagannath S. Nephrotic proteinuria associated with high-dose pamidronate in multiple myeloma. Br J Haematol. 2002;119:496–9.

    Article  Google Scholar 

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

    Article  Google Scholar 

  6. Neyra JA, Vaidya OU, Hendricks A, Sambandam KK. Collapsing focal segmental glomerulosclerosis resulting from a single dose of zoledronate. Nephron Extra. 2014;4:168–74.

    Article  Google Scholar 

  7. Miura N, Mizuno N, Aoyama R, Kitagawa W, Yamada H, Nishikawa K, Imai H. Massive proteinuria and acute renal failure after oral bisphosphonate (alendronate) administration in a patient with focal segmental glomerulosclerosis. Clin Exp Nephrol. 2009;13:85–8.

    Article  Google Scholar 

  8. Prikis M, Gibson PC, Weise WJ. Alendronate-associated focal segmental glomerulosclerosis. NDT Plus. 2009;2:91–2.

    PubMed  Google Scholar 

  9. Jia N, Cormack FC, Xie B, Shiue Z, Najafian B, Gralow JR. Collapsing focal segmental glomerulosclerosis following long-term treatment with oral ibandronate: case report and review of literature. BMC Cancer. 2015;15:535.

    Article  Google Scholar 

  10. Komada T, Morishita Y, Kitamura M, Iwazu K, Numata A, Kobayashi T, Yamamoto H, Akimoto T, Saito O, Ando Y, Takemoto F, Muto S, Yumura W, Kusano E. Acute kidney injury in a patient with nephrotic syndrome due to focal segmental glomerular nephritis induced by a single oral administration of high-dose bisphosphonate (minodronate). Intern Med. 2013;52:1383–7.

    Article  Google Scholar 

  11. Perazella MA, Markowitz GS. Bisphosphonate nephrotoxicity. Kidney Int. 2008;74:1385–93.

    Article  CAS  Google Scholar 

  12. Roelofs AJ, Thompson K, Gordon S, Rogers MJ. Molecular mechanisms of action of bisphosphonates: current status. Clin Cancer Res. 2006;12:6222s-s6230.

    Article  CAS  Google Scholar 

  13. Rogers MJ, Gordon S, Benford HL, Coxon FP, Luckman SP, Monkkonen J, Frith JC. Cellular and molecular mechanisms of action of bisphosphonates. Cancer. 2000;88:2961–78.

    Article  CAS  Google Scholar 

  14. Miller PD. The kidney and bisphosphonates. Bone. 2011;49:77–81.

    Article  CAS  Google Scholar 

  15. Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, Ebetino FH, Rogers MJ. Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonate. J Pharmacol Exp Ther. 2001;296:235–42.

    CAS  PubMed  Google Scholar 

  16. Stokes MB, Valeri AM, Markowitz GS, D’Agati VD. Cellular focal segmental glomerulosclerosis: clinical and pathologic features. Kidney Int. 2006;70:1783–92.

    Article  CAS  Google Scholar 

  17. Chun MJ, Korbet SM, Schwartz MM, Lewis EJ. Focal segmental glomerulosclerosis in nephrotic adults: presentation, prognosis, and response to therapy of the histologic variants [presentation]. J Am Soc Nephrol. 2004;15:2169–77.

    Article  Google Scholar 

  18. Schwartz MM, Korbet SM, Rydell J, Borok R, Genchi R. Primary focal segmental glomerular sclerosis in adults: prognostic value of histologic variants. Am J Kidney Dis. 1995;25:845–52.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Nephrology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan

    Takuya Morinishi, Ryo Konishi, Erina Ono, Koji Takaori & Sayako Maeda

  2. Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

    Aya Nawata

Authors
  1. Takuya Morinishi
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  2. Aya Nawata
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  3. Ryo Konishi
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  4. Erina Ono
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  5. Koji Takaori
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  6. Sayako Maeda
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Correspondence to Takuya Morinishi.

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Morinishi, T., Nawata, A., Konishi, R. et al. Nephrotic syndrome with acute kidney injury due to focal segmental glomerulosclerosis following long-term treatment with minodronate. CEN Case Rep 11, 120–125 (2022). https://doi.org/10.1007/s13730-021-00637-3

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  • DOI: https://doi.org/10.1007/s13730-021-00637-3

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