Objective:

Renal toxicity and hypocalcemia are two commonest adverse effects of zoledronic acid reported in cancer patients with bone metastasis. Similar data are lacking in postmenopausal women with osteoporosis treated with zoledronic acid infusion. We aimed to evaluate the effects of annual treatment of postmenopausal osteoporotic women with intravenous infusion of zoledronic acid on their renal and hepatic functions. The effects of the drug on the biochemical parameters of the patients were also assessed.

Methods:

We reviewed the electronic medical records (EMRs) of postmenopausal women with osteoporosis treated with 5 mg of zoledronic acid once in a year. Changes in the serum levels of calcium, phosphorus, alkaline phosphatase, creatinine, blood urea nitrogen (BUN) as well as alanine and aspartate transaminases were determined after infusing zoledronic acid relative to the base line results. Information about the documented adverse effects of zoledronic acid were extracted from the EMRs.

Results:

All the biochemical parameters, except calcium, demonstrated no statistically significant changes in their serum levels when the results, before and after treatment with zoledronic acid, were compared. The serum Ca level slightly and significantly decreased from 9.6±0.6 mg/ dl (before treatment) to 9.4±0.9 mg/dl (after treatment) (p=0.018). A few but important adverse effects associated with zoledronic acid infusion in the patients were influenzalike symptoms (6), myalgia (4), arthralgia (4), headache (4), and pyrexia (3).

Conclusions:

The once in a year use of zoledronic acid infusion for osteoporosis in postmenopausal women was not associated with a statistically significant renal and hepatic adverse effects. Among the biochemical parameters evaluated, only serum calcium level decreased slightly and statistically significantly after using zoledronic acid infusion, despite prophylactic calcium use before treatment.

Keywords: bisphosphonate, hepatic function, renal function, serum calcıum, zoledronic acid