[Therapy of hypercalcemia with ibandronate in case of acute renal failure].
Hypercalcaemia is a common complication of malignancies associated with bone destruction. Besides, benign diseases as sarcoidosis or hyperparathyroidism may lead to hypercalcaemia. The main principles of modern therapy contain a forced diuresis as well as the application of bisphosphonates. Latter substances bear the danger of developing a renal insufficiency. Here, we report the case of a female patient, suffering from primary hyperparathyroidism with severe hypercalcaemia and calcium levels up to 6 mmol/l, who developed acute renal failure. We treated the patient with forced diuresis and repeated infusions of ibandronate (5 x 6 mg ibandronate). Even if lowering the serum levels of calcium only for a short time after each application, yet we could improve renal function by these means. Only after performing a parathyroidectomy, we could see a sustained decline of calcium levels. This case report supports the results of other publications, that have reported the missing nephrotoxic effect of ibandronate compared to other bisphosphonates.
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen gGmbH, Bremserstrasse 49, Ludwigshafen. bergnerr@klilu.de
R
R
Bergner
D M
DM
Henrich
M
M
Hoffmann
D
D
Bruckner
M
M
Uppenkamp
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000188:drug therapy*; D000236:Adenoma / Q000150:complications / Q000601:surgery; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000188:drug therapy*; D000077557:Ibandronic Acid; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications / Q000601:surgery; D016105:Parathyroidectomy; D012008:Recurrence
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D010281:Parathyroid Hormone; D003404:Creatinine; D002118:Calcium; D000077557:Ibandronic Acid