Renal safety of zoledronic acid in patients with osteoporosis: a retrospective study

Abstract

IntroductionThis study aimed to investigate the renal safety of Zoledronic Acid (ZOL) in patients with osteoporosis (OP). MethodsA total of 1,523 patients with primary OP who received ZOL from January 2008 to October 2020 at our hospital were retrospectively analyzed. Baseline and one-year post-infusion renal function index data were analyzed in relation to clinical characteristics and comorbidities. Furthermore, the changes in renal function between a three-year consecutive infusion and a single infusion of ZOL were compared. ResultsIn our study, patients with diabetes mellitus had a signi cantly lower estimated glomerular ltration rate than those without after one year of ZOL infusion, and their creatinine (Cr) and cystatin C (CysC) levels were signi cantly higher (all P < 0.05). Patients with malignant tumors had a signi cantly lower estimated glomerular ltration rate and higher Cr levels than those without (all P < 0.05). CysC levels were signi cantly higher in patients aged 65 and older and those with hypertension than in their counterparts (all P < 0.05). No adverse renal events such as acute kidney injury were detected. There were no signi cant differences in renal function index between the three-year continuous infusion group and the single infusion group after one year of infusion(s) (all P > 0.05). ConclusionZOL infusion shows good renal safety in OP patients. Continuous infusion of ZOL did not exert a signi cant impact on renal function when compared to single infusion. However, the age of 65 years or older and comorbidities such as hypertension, diabetes mellitus, or malignant tumors may represent risk factors that predict adverse renal effects of ZOL infusion.