Pamidronate for HCM provides limited impact in patients with renal dysfunction

In patients with pre-existing renal dysfunction, use of pamidronate for the treatment of hypercalcaemia of malignancy (HCM) may provide little benefit on renal function at doses up to 90 mg, suggests a study.

“Few studies have been conducted investigating the use of bisphosphonates in HCM in the setting of renal dysfunction,” the investigators noted.

The investigators sought to compare the incidence of acute kidney injury (AKI) within 7 days of receiving pamidronate for the treatment of HCM with pre-existing renal dysfunction compared with normal renal function at the time of treatment administration. They also explored the effects of pamidronate doses and infusion rates on the safety and efficacy in those with pre-existing renal dysfunction.

This retrospective chart review included patients who received pamidronate for the treatment of HCM at a community teaching hospital in Indiana, US, from 1 January 2013 to 31 May 2017.

Of the 141 patients who received pamidronate for the treatment of HCM, 116 had normal baseline renal function and 25 had pre-existing renal dysfunction prior to medication administration.

AKI developed in two patients (8 percent) in the pre-existing renal dysfunction group as compared with four (3.4 percent) in those without the pre-existing condition (p=0.288). In addition, the incidence of AKI did not differ based on the dosage of pamidronate given (p=0.762) or infusion rates (p=0.373) among patients with pre-existing renal dysfunction.