Nephrotic proteinuria associated with high-dose pamidronate in multiple myeloma.
Five patients receiving increased dose or frequency of pamidronate beyond the recommended dose (90 mg/monthly) exhibited nephrotic proteinuria (range 3.96-24 g/24 h). On dose reduction or discontinuation, three of these patients showed decreased proteinuria to normal levels (< 1 g/24 h), and proteinuria decreased to 4.5 g/24 h from a peak of 24 g/24 h in one patient. One patient on haemodialysis (hence not evaluable) had proteinuria of 2 g/24 h and elevated creatinine levels. One other patient continued to show elevated creatinine levels (272.8 micro mol/l). Renal biopsies obtained in two patients revealed focal segmental glomerulosclerosis.
Desikan
Raman
R
Myeloma and Transplantation Program, Saint Vincent's Comprehensive Cancer Center, New York, NY 10011, USA. kdesikan@salick.com
Veksler
Yuliya
Y
Raza
Syed
S
Stokes
Barry
B
Sabir
Tariq
T
Li
Zu Jun
ZJ
Jagannath
Sundar
S
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001536:Bence Jones Protein / Q000652:urine; D003404:Creatinine / Q000652:urine; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007678:Kidney Glomerulus / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000652:urine; D000077268:Pamidronate; D011507:Proteinuria / Q000139:chemically induced*
D000970:Antineoplastic Agents; D004164:Diphosphonates; D001536:Bence Jones Protein; D003404:Creatinine; D000077268:Pamidronate