Use of Bisphosphonates in Chronic Kidney Disease

Ozmen,

doi:10.4021/wjnu5e

Cited by 3 publications

(4 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies were conducted that reported the efficacy of pamidronate and bisphosphonates in general for the treatment of hypercalcemia in oncology patients, but these patients did not have renal impairment [ 4 , 5 ]. There are other studies about the use of bisphosphonates in renal failure, but there is very little information about pamidronate [ 6 , 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…There are additional treatment regimens according to the correlating etiology, some of which include calcitonin and bisphosphonates. A literature search was conducted, showing theoretical evidence based on a pharmacokinetics study, which showed that pamidronate may be used in patients with renal failure based on theoretical pharmacokinetics data [ 3 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report

et al. 2018

View full text Add to dashboard Cite

Patient: Female, 60Final Diagnosis: Hypercalcemia secondary to malignancySymptoms: HypercalcemiaMedication: —Clinical Procedure: —Specialty: NephrologyObjective:Unusual clinical courseBackground:Hypercalcemia is a common complication in the intensive care unit (ICU). It can be a result of diverse etiologies, such as malignancy. In this case, bisphosphonates can serve as an effective therapeutic option. However, bisphosphonates are not safe to use in patients with end stage renal disease.Case Report:We report a case of severe hypercalcemia possibly secondary to bone metastasis. The patient is known to have end-stage renal disease (ESRD) and undergoing dialysis 3 times a week. She had severe persistent hypercalcemia which did not resolve with regular measures or calcitonin. The literature was searched for the possibility of administering bisphosphonate as a treatment option. It was found that pamidronate pharmacokinetics can be safe and effective in end-stage renal disease patients. Therefore, Pamidronate was administered, showing effective results with regards to the level of calcium and no observed adverse effects. Re-dosing was required at an 8-week interval, with no adverse effects.Conclusions:Pamidronate is a safe option to use in treating hypercalcemia in end-stage renal disease patients on dialysis. This can be especially beneficial in patients with sustained hypercalcemia secondary to malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report

et al. 2018

View full text Add to dashboard Cite

show abstract

“…30 Some clinicians have advocated dosage adjustments for these patients, 31 including recommendations to reduce the oral bisphosphonate dose by half. 32 However, there is little evidence to support such recommendations. Unfortunately, long-term pharmacokinetic studies looking at the outcomes of bisphosphonate dosage adjustment in CKD are not available, 33 which may be due in part to potential liability associated with studying a contraindicated use, the complexity of this patient population, and the existence of other, more urgent health priorities for patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

Sadowski

Lyder²,

Yuksel

2016

CJHP

View full text Add to dashboard Cite

ABSTRACTBackground: Clinicians often face challenges in deciding how to treat osteoporosis in patients with chronic kidney disease. As background to offering guidance to health care providers, it is important to understand their practices and beliefs.Objectives: To describe the practices and beliefs of pharmacists regarding use of bisphosphonates for patients with osteoporosis and chronic kidney disease.Methods: A cross-sectional survey of pharmacists working in hospitals and related health care settings was conducted. A 34-item online questionnaire was developed consisting of 4 sections: demographic characteristics, practices, beliefs, and comfort level with making decisions about osteoporosis treatment. An e-mail invitation was sent to members of the Canadian Society of Hospital Pharmacists (n = 2499) in November 2012.Results: A total of 367 pharmacists completed the survey. Most of the respondents were women (258 [70%]), had more than 10 years in practice (213 [58%]), and were providing care to 1 or more osteoporosis patients per week (212 [58%]). Over one-third (150 [41%]) stated that they would use a bisphosphonate for patients with creatinine clearance (CrCl) of 15–30 mL/min, but more than half (207 [56%]) stated that they would avoid a bisphosphonate (and recommend another medication) for patients with CrCl below 15 mL/min. Forty-eight percent (176/363) agreed that oral bisphosphonates could be used for patients with renal failure (defined as CrCl < 30 mL/min), so long as dosage adjustments are made. More than half (206/363 [57%]) believed that the adverse effects of oral bisphosphonates increase for patients with renal failure. Respondents expressed a low level of comfort in assessing and initiating osteoporosis treatment for patients with renal failure.Conclusions: Pharmacists had varying beliefs about managing osteoporosis in patients with chronic kidney disease. This study highlights the need for practice tools and targeted education addressing the use of bisphosphonates for these patients.RÉSUMÉContexte : Les cliniciens sont souvent confrontés à des défis lorsqu’ils doivent choisir un traitement contre l’ostéoporose chez les patients atteints d’insuffisance rénale chronique. Afin d’être en mesure de guider les fournisseurs de soins de santé, il importe de comprendre leurs pratiques et leurs croyances.Objectif : Offrir un portrait des pratiques et croyances des pharmaciens en ce qui a trait à l’emploi des bisphosphonates chez les insuffisants rénaux chroniques atteints d’ostéoporose.Méthodes : Une enquête transversale a été réalisée auprès de pharmaciens exerçant en établissements de santé. Un questionnaire en ligne a été élaboré. Il contenait 34 éléments répartis en 4 sections, soit : les caractéristiques démographiques; les pratiques; les croyances; et le degré d’aisance en ce qui a trait au choix d’un traitement contre l’ostéoporose. Un courriel d’invitation a été envoyé aux membres de la Société canadienne des pharmaciens d’hôpitaux (n = 2499) en novembre 2012.Résultats : Au total, 367 pharmaciens ont participé au sondage. La plupart des répondants étaient des femmes (258 [70 %]), possédaient plus de 10 années de pratique (213 [58 %]) et fournissaient hebdomadairement des soins à au moins un patient ostéoporotique (212 [58 %]). Plus d’un tiers (150 [41 %]) ont indiqué qu’ils emploieraient un bisphosphonate chez les patients affichant une clairance de la créatinine (ClCr) entre 15 et 30 mL/min, mais plus de la moitié (207 [56 %]) ont affirmé qu’ils n’en utiliseraient pas (et qu’ils recommandaient un autre médicament) chez les patients présentant une ClCr en deçà de 15 mL/min. Quarante-huit pour cent (176/363) ont affirmé que les bisphosphonates oraux pouvaient être employés pour les patients présentant une insuffisance rénale (définie comme une ClCr < 30 mL/min), pourvu que l’on procède à des ajustements posologiques. Plus de la moitié (206/363 [57 %]) croyaient que les effets indésirables des bisphosphonates oraux sont plus importants chez les patients souffrant d’insuffisance rénale. Les répondants ont indiqué être peu à l’aise lorsque vient le temps d’évaluer et d’amorcer un traitement contre l’ostéoporose chez les insuffisants rénaux.Conclusions : Les pharmaciens adhéraient à diverses croyances en ce qui touche la prise en charge de l’ostéoporose chez les insuffisants rénaux. La présente étude met en évidence le besoin d’outils pour la pratique ainsi que d’enseignement ciblé portant sur l’emploi des bisphosphonates chez les patients atteints d’insuffisance rénale.

show abstract

“…In a study performed by Hamdy et al, 75% of pre-dialysis CKD patients had abnormal bone histology (74% osteitis fibrosa, 19% mixed bone disease, 1% osteomalacia, 1% aluminium bone disease, 5% a dynamic bone disease), without clinical, biochemical or radiographic evidence of bone disease [4]. Factors that predispose to low bone mineral density (BMD) in patients with CKD are age, gender, the onset of menopause, sedentary life style, low calcium intake, vitamin-D deficiency and hyperparathyroidism [5].…”

Section: Introductionmentioning

confidence: 99%

The frequency of bone fractures among patients with chronic kidney disease not on dialysis: two-year follow-up

Figurek

Vlatković

Vojvodic

et al. 2017

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

Introduction. Renal osteodystrophy is a severe complication of chronic kidney disease (CKD) that increases morbidity and mortality in these patients. Mineral and bone disorder starts early in CKD and affects the incidence of bone fractures. The aim of this study was to observe the frequency of diverse bone fractures in patients with CKD not on dialysis.Methods. This cohort study included 68 patients that were followed during the two-year period. The patients were divided into two cohorts: one that developed bone fractures and the other that did not. There were 35 (51.5%) men and 33 (48.5%) women. The mean age of patients ranged 62.88±11.60 years. During follow-up serum values of chronic kidney disease -mineral and bone indicators were measured. The methods of descriptive and analytical statistics were used in order to analyze obtained data.Results. During this two-year follow-up seven patients developed bone fractures. Among them, females dominated (6 patients) compared to males (only 1 patient). The most common were fractures of forearm. The mean level of parathyroid hormone (PTH) at the beginning of the monitoring was higher in the group of patients with bone fractures (165.25 ± 47.69 pg/mL) in regard to another group (103.96 ± 81.55 pg/mL). After two-year follow-up, this difference became statistically significant at the level p < 0.05. Patients that developed bone fractures had higher FRAX (Fracture Risk Assessment) score compared to another group.Conclusion. In our study, about 10% of patients had bone fractures in the two-year follow-up period. Patients who developed fractures had a higher PTH level and FRAX score.

show abstract

Use of Bisphosphonates in Chronic Kidney Disease

Cited by 3 publications

References 36 publications

Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report

Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report

Bisphosphonates for Osteoporosis in Patients with Renal Insufficiency: Pharmacists’ Practices and Beliefs

The frequency of bone fractures among patients with chronic kidney disease not on dialysis: two-year follow-up

Contact Info

Product

Resources

About