Acute renal failure during treatment with Zoledronate in cancer patients.

Background: Standard treatment for bone metastases is based on bisphosphonates such as zoledronic acid. The objective of this study was to evaluate the incidence of acute renal failure during treatment with Zoledronate and to analyze its correlated factors.

Materials and methods: This is a retrospective study carried out at the medical oncology department of Habib Bourguiba University Hospital in Sfax, between January 2022 and March 2022. The creatinine dosage was carried out using the Jaffe-type colorimetric method. Acute renal failure was defined by the Kidney disease Improving Global Outcomes criteria.

Results: 48 patients were included. The average age was 56.9 ± 10.7 years with a sex ratio (M/F) equal to 0.5. The average weight of the patients was equal to 68.5 ± 16.4 kg. 62.5% of patients were followed for breast cancer, 12.5% had lung cancer and 12.5% had prostate adenocarcinoma. The mean serum creatinine before the start of treatment was equal to 74.3 ± 34.3 µmol/l 50.84 ± 0.11 mg/dl). The mean pre-therapeutic clearance was 94.1 ± 40.2 ml/min with 4 cases of moderate renal impairment (8.3%). Acute renal failure according to KDIGO during treatment with Zoledronic acid was observed in 9 cases (18.8%), thus requiring a dose reduction. Acute renal failure was significantly associated initial clearance <60 ml/min and low weight of 53.44 kg (p = 0.003 and p = 0.01 respectively), in multivariate analysis.

Conclusion: Our study concluded that factors associated with acute renal failure were low weight and clearance less than 60 ml/min.