title: Safe and tolerable one-hour pamidronate infusion for multiple myeloma patients.
abstract: BACKGROUND
  Once a month, patients with multiple myeloma received an infusion of bisphosphonates, principally to reduce osteoclastic bone resorption. Recommended infusion time for pamidronate is 2 hours in the US and 4 hours in Europe because of its potential nephrotoxicity. From 2003, a 90 mg infusion of pamidronate was provided over 1 hour to patients with no pre-existing renal impairment, in the Daily Care Unit at Uddevalla Hospital.
  
  
  METHODS
  Retrospective analysis of the renal deterioration, serum calcium, and adverse effects in patients with multiple myeloma treated with 1-hour pamidronate 90 mg infusion from January 2003 to April 2007.
  
  
  RESULTS
  Seventy-nine patients provided valuable data. A total number of 846 infusions were given and the median number of infusion to each patient was 11. Significant creatinine elevation was seen in 7 patients (8.9%), after 19 infusions (2.2%). Renal deterioration occurred in 5 of these 7 patients, which was related to progress of the myeloma or opportunistic infections. Prevalence of infusion-related events was 0.8% and the mean total S-Ca was 0.05 mmol/L lower than the baseline.
  
  
  CONCLUSIONS
  Few events of renal deterioration, hypocalcemia, or other adverse effects resulted from a 1-hour pamidronate 90 mg infusion for multiple myeloma patients with no pre-existing renal impairment.
authors.affiliation: Department of Internal Medicine, Uddevalla Hospital, Uddevalla, Sweden.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chantzichristos
authors.forename: Björn
authors.initials: B
authors.lastname: Andréasson
authors.forename: Peter
authors.initials: P
authors.lastname: Johansson