Effect of pamidronate infusion time on renal function in patients with multiple myeloma

Introduction

Administration of biphosphonates in patients with renal failure requires a dosage adjustment.

Objectives

Analyse renal function evolution in multiple myeloma patients after reducing infusion time for 90 mg pamidronate by 2 h.

Methods

In 2007, a retrospective study was carried out on all patients who presented multiple myeloma and bone metastasis treated with pamidronate administered every 4 h. Following a review of the literature, a protocol for administering pamidronate every 2 h was created in partnership with Haematology, and a specific dose reduction framework was established for patients with baseline renal failure. Additionally, a prospective follow-up study of those patients’ renal function was completed to analyse its evolution after the change in infusion time.

Results

A total of six patients received 90 mg pamidronate every 4 h. 33.32% of the patients (2/6) presented baseline renal insufficiency, and therefore needed to have the pamidronate dose adjusted according to the new protocol. Subsequently, all of them received the treatment every 2 h, and one patient (16.6%) experienced altered renal function after two treatment cycles.

Discussion

Reducing administration time for pamidronate from four to 2 h did not lead to significant variations in patients’ renal function. This therapeutic practice can improve patients’ quality of life by shortening their hospital stay without aggravating their renal function.