Intravenous therapy with a bisphosphonate can result in nephrotoxicity. Perazella and Markowitz identified risk factors for this avoidable complication. The authors are from Yale and Columbia Universities.
Patterns of nephrotoxicity:
(1) acute tubular necrosis
(2) focal segmental glomerulosclerosis (FSGS)
Risk factors for nephrotoxicity:
(1) excessive dose of the bisphosphonate, including failure to adjust the dose for pre-existing chronic renal disease
(2) failure to monitor serum creatinine prior to each intravenous dose
(3) failure to withhold therapy from someone with renal insufficiency
Additional risk factors to consider:
(1) concurrent therapy with other nephrotoxic drugs
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