[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.
Bergner
R
R
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen gGmbH, Bremserstrasse 49, Ludwigshafen. bergnerr@klilu.de
Henrich
D M
DM
Hoffmann
M
M
Bruckner
D
D
Uppenkamp
M
M
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