Renal Failure with the Use of Zoledronic Acid

To the Editor: Zoledronic acid (Zometa, Novartis Pharmaceuticals) is a potent bisphosphonate that inhibits bone resorption. In trials of treatment for bone metastases, 9 to 15 percent of the patients who received 4 mg of zoledronic acid over a 15-minute period had renal deterioration, defined by elevations in the serum creatinine level. 1 , 2 With marketed use of the drug, renal deterioration progressing to renal failure and dialysis has been reported. Although the causes of renal deterioration are multifactorial, acute tubular necrosis has been described as a potential mechanism associated with zoledronic acid. 3 We identified 72 cases in the Food and . . .