Renal Safety of Zoledronic Acid in Patients with Osteoporosis: A Retrospective Study

Abstract

Abstract Introduction This study aimed to investigate the renal safety of Zoledronic Acid (ZOL) in patients with osteoporosis (OP). Methods A 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. Results In our study, patients with diabetes mellitus had a significantly lower estimated glomerular filtration rate than those without after one year of ZOL infusion, and their creatinine (Cr) and cystatin C (CysC) levels were significantly higher (all P < 0.05). Patients with malignant tumors had a significantly lower estimated glomerular filtration rate and higher Cr levels than those without (all P < 0.05). CysC levels were significantly 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 significant 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). Conclusion ZOL infusion shows good renal safety in OP patients. Continuous infusion of ZOL did not exert a significant 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. Mini Abstract The renal safety of Zoledronic Acid treatment in osteoporosispatients remains incompletely elucidated. We found that the infusion has good renal safety in osteoporosis patients, but careful monitoring of renal function is recommended for patients who are aged 65 years or older and those with comorbidities such as hypertension, diabetes mellitus, or malignant tumors.