{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:25:34Z","timestamp":1787243134434,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although intravenous (IV) bisphosphonates are first-line medications for the management of hypercalcemia, studies examining their use in patients with preexisting renal dysfunction are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to describe the safety and efficacy of pamidronate and zoledronic acid in the treatment of hypercalcemia in patients with baseline renal dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted of IV pamidronate and zoledronic acid in adult patients with hypercalcemia and creatinine clearance (CrCl) &lt;60 mL\/min. The primary endpoint was incidence of all-grade serum creatinine (SCr) elevations. Secondary endpoints included refractory hypercalcemia, hypocalcemia, osteonecrosis of the jaw (ONJ), corrected serum calcium (CSC) decrease \u22651.0 mg\/dL by day 7 of bisphosphonate administration, and normalization of CSC \u226410.5 mg\/dL by days 10 and 30.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 113 patients were included (n = 55 pamidronate, n = 58 zoledronic acid). The primary endpoint of all-grade SCr elevation occurred in 28 (24.8%) patients. Grades 3\/4 SCr elevations occurred in 10.9% of patients treated with pamidronate and 1.7% of patients receiving zoledronic acid. Approximately 16% and 14% of patients developed grades 1 and 2 hypocalcemia, respectively, and there were no cases of ONJ. Overall, 64.6% of patients achieved normalization of CSC by day 10, and there were no statistical differences between bisphosphonate type and renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The analysis suggests an association between IV bisphosphonates and increased rates of SCr elevations among patients with preexisting renal dysfunction. Future prospective studies are necessary to elucidate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1060028020953501","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T04:30:48Z","timestamp":1598502648000},"page":"303-310","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Safety of Intravenous Bisphosphonates for the Treatment of Hypercalcemia in Patients With Preexisting Renal Dysfunction"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4043-380X","authenticated-orcid":false,"given":"Shannon","family":"Palmer","sequence":"first","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Frank","family":"Tillman","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preetika","family":"Sharma","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Auten","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"},{"name":"University of North Carolina, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Owen","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Clark","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"},{"name":"University of North Carolina, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine P.","family":"Morgan","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"},{"name":"University of North Carolina, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,8,27]]},"reference":[{"key":"bibr1-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613507530"},{"key":"bibr2-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650061413"},{"key":"bibr3-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp042806"},{"key":"bibr4-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.011155I"},{"key":"bibr5-1060028020953501","doi-asserted-by":"publisher","DOI":"10.4103\/1947-2714.170600"},{"key":"bibr6-1060028020953501","doi-asserted-by":"publisher","DOI":"10.4065\/83.9.1032"},{"key":"bibr7-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.356"},{"key":"bibr8-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.25266"},{"key":"bibr9-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.2.558"},{"key":"bibr10-1060028020953501","doi-asserted-by":"publisher","DOI":"10.1177\/0897190019883162"},{"key":"bibr11-1060028020953501","unstructured":"Aredia [package insert]. 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