Nephrotic syndrome after oral bisphosphonate (alendronate) administration in a patient with osteoporosis.
Summary of "Nephrotic syndrome after oral bisphosphonate (alendronate) administration in a patient with osteoporosis."
Alendronate is a widely used bisphosphonate in the treatment of osteoporosis. Although it has been proven to be a very useful drug, it has some side effects as well. In this paper, we describe a case of nephrotic syndrome due to alendronate administration. A 36-year-old man was admitted to the nephrology outpatient clinic with widespread edema 4 months after initiation of alendronate. He had a 13-kg weight gain within a 2-week period. He had no clinical or laboratory problems apart from osteoporosis, which was the indication for initiation of the drug. Physical examination at admission was unremarkable, but for nephrotic edema. Laboratory studies revealed nephrotic range proteinuria (13.5 g/day), normal renal function, hypoalbuminemia (1.7 g/dl), and also hypercholesterolemia (400 mg/dl). A kidney biopsy was performed. Light microscopic evaluation revealed a slight increase in mesangial cells and matrix; however, no abnormalities in the tubules or interstitium were noted. Alendronate was withdrawn and diuretic therapy was initiated. Patient's weight gradually decreased from 84 to 67 kg within a 1-week period. No other drugs for the treatment of nephrotic syndrome were administered. During the clinical course, serum creatinine remained stable, and proteinuria gradually decreased and disappeared 40 days after stopping alendronate. It was noted that alendronate administration can give rise to nephrotic syndrome, while discontinuation of this drug may improve the pathology without any specific treatment.
Affiliation
Department of Nephrology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Kartaltepe mah. Caglayan sok. No 9/5 Bakirkoy, Istanbul, Turkey, murvetyilmaz@hotmail.com.
Journal Details
This article was published in the following journal.
Name: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and
ISSN: 1433-2965
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22278748
- DOI: http://dx.doi.org/10.1007/s00198-011-1836-2
Medical and Biotech [MESH] Definitions
Nephrotic Syndrome
A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.
Aids-associated Nephropathy
Renal syndrome in human immunodeficiency virus-infected patients characterized by nephrotic syndrome, severe proteinuria, focal and segmental glomerulosclerosis with distinctive tubular and interstitial changes, enlarged kidneys, and peculiar tubuloreticular structures. The syndrome is distinct from heroin-associated nephropathy as well as other forms of kidney disease seen in HIV-infected patients.
Evidence-based Dentistry
An approach or process of practicing oral health care that requires the judicious integration of systematic assessments of clinical relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. (from J Am Dent Assoc 134: 689, 2003)
Nephrosis
Pathological processes of the KIDNEY without inflammatory or neoplastic components. Nephrosis may be a primary disorder or secondary complication of other diseases. It is characterized by the NEPHROTIC SYNDROME indicating the presence of PROTEINURIA and HYPOALBUMINEMIA with accompanying EDEMA.
Administration, Oral
The giving of drugs, chemicals, or other substances by mouth.
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