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Renal safety of zoledronic acid in patients with osteoporosis: a retrospective study

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Abstract

Introduction

This study aimed to investigate the renal safety of Zoledronic Acid (ZOL) in patients with osteoporosis (OP).

Methods

A total of 1379 patients (baseline estimated glomerular filtration rate, eGFR ≥ 60 mL/min/1.73 m2) with primary OP who received ZOL from January 2008 to October 2020 at our hospital were retrospectively analyzed. Baseline and the changes in renal function within 1 year following infusions were collected, the incidence of renal impairment (eGFR < 60 mL/min/1.73 m2 or a > 25% reduction in the eGFR from baseline) was noted and the risk factors were analyzed. Furthermore, the changes in renal function between a 3-year consecutive infusion and a single infusion of ZOL were compared.

Results

Renal impairment occurred in 8.05% of patients, who with a significantly higher age, Charlson Comorbidity Index (CCI), smoking history, combination of hypertension or diabetes mellitus and worse renal function indicators (all P < 0.05). Binary logistic regression analysis showed that higher CCI (≥5) or smoking history or the baseline eGFR <90 mL/min/1.73 m2 were the risk factors for renal impairment (all P < 0.05). Patients of 3-year continuous infusion group had a significantly greater drop in the eGFR levels than the single infusion group after 1 year of infusion(s) (P < 0.05).

Conclusion

Attention should be given to possible potential renal impairment following ZOL infusion in clinical practice for the management of OP, particularly in patients with higher CCI (≥5) or smoking history or the baseline eGFR <90 mL/min/1.73 m2. Continuous infusion of ZOL exerts a significant impact on renal function when compared to single infusion and intensive monitoring of renal function is necessary.

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Authors and Affiliations

  1. Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China

    Yanhua Ma, Shen Xu, Zhongyue Xu, Ying Zhang, Chunyan Lu, Decai Chen & Qin Wang

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  1. Yanhua Ma
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  2. Shen Xu
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  3. Zhongyue Xu
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Contributions

Q.W. and D.C.C. designed the study. Y.H.M. collected data and wrote the manuscript. Q.W., D.C.C. and C.Y.L. made critical revisions to the manuscript. S.X., Z.Y.X. and Y.Z. helped with the data collection and analysis. All authors contributed to the article and approved the submitted version.

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Correspondence to Qin Wang.

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The studies involving human participants were reviewed and approved by the Medical Ethics Committee of West China Hospital of Sichuan University. For this type of study formal consent is not required.

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Ma, Y., Xu, S., Xu, Z. et al. Renal safety of zoledronic acid in patients with osteoporosis: a retrospective study. Endocrine 83, 459–465 (2024). https://doi.org/10.1007/s12020-023-03567-5

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