title: Effect of intravenous hydration in patients receiving bisphosphonate therapy.
abstract: BACKGROUND
  Patients with advanced cancers are at high risk for bone metastases, which accelerate bone resorption and skeletal complications. Therefore, bisphosphonates, which are strong inhibitors of bone resorption, are widely used to prevent pathological fractures, pain and tumour-induced hypercalcaemia. Intravenous infusion of bisphosphonate is associated with dose- and infusion rate-dependent adverse renal effects.
  
  
  OBJECTIVE
  The present study investigated the effect of hydration on bisphosphonate efficacy and safety.
  
  
  METHODS
  The 600-bed CHOV Hospital (Neufchâteau, France) and the Université de Lorraine (Nancy, France).
  
  
  METHODS
  Patients who received pamidronate or zoledronic acid treatments were identified: 50 patients [16 of whom were hydrated and 34 of whom were non-hydrated]. Data on serum calcium levels, creatinine clearance and clinical tolerance were collected. Main outcome measure The impact of hydration on these parameters was analysed between day 1 and day 7.
  
  
  RESULTS
  Bisphosphonate normalized calcaemia and hydration did not induce further reduction of calcium levels. Patient kidneys were significantly preserved by hydration in both groups (median clearance: +6.2%), whereas dehydrated patients had lower creatinine clearance (median clearance: -1.1%). Hydration did not influence other clinical or biological parameters tested.
  
  
  CONCLUSIONS
  Hydration plays an important role in the treatment of hypercalcaemia by pamidronate and zoledronic acid: it enhances kidney protection (i.e., creatinine clearance).
authors.affiliation: CHOV, Site de Neufchâteau, Pharmacie, 1280, Avenue de la Division Leclerc, 88300, Neufchâteau, France.
authors.forename: David
authors.initials: D
authors.lastname: Attivi
authors.forename: Gaétan
authors.initials: G
authors.lastname: Kosmalski
authors.forename: Claire
authors.initials: C
authors.lastname: Zeghmouli
authors.forename: Stéphane
authors.initials: S
authors.lastname: Gibaud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced / Q000628:therapy*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015532:Rehydration Solutions / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D004164:Diphosphonates; D015532:Rehydration Solutions