Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report

BACKGROUND Hypercalcemia is a common complication in the intensive care unit (ICU). It can be a result of diverse etiologies, such as malignancy. In this case, bisphosphonates can serve as an effective therapeutic option. However, bisphosphonates are not safe to use in patients with end stage renal...

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Bibliographic Details
Published in:The American journal of case reports 2018-09, Vol.19, p.1087-1089
Main Authors: Mahmoud, Sara, Mitwally, Hassan, El Zeer, Hani Soliman, El Madhoun, Ihab, Khatib, Mohamad
Format: Article
Language:English
Subjects:
Bone Density Conservation Agents - therapeutic use
Bone Neoplasms - complications
Bone Neoplasms - secondary
Breast Neoplasms - pathology
Female
Humans
Hypercalcemia - drug therapy
Hypercalcemia - etiology
Kidney Failure, Chronic - therapy
Middle Aged
Pamidronate - therapeutic use
Renal Dialysis
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Summary:BACKGROUND Hypercalcemia is a common complication in the intensive care unit (ICU). It can be a result of diverse etiologies, such as malignancy. In this case, bisphosphonates can serve as an effective therapeutic option. However, bisphosphonates are not safe to use in patients with end stage renal disease. CASE REPORT We report a case of severe hypercalcemia possibly secondary to bone metastasis. The patient is known to have end-stage renal disease (ESRD) and undergoing dialysis 3 times a week. She had severe persistent hypercalcemia which did not resolve with regular measures or calcitonin. The literature was searched for the possibility of administering bisphosphonate as a treatment option. It was found that pamidronate pharmacokinetics can be safe and effective in end-stage renal disease patients. Therefore, Pamidronate was administered, showing effective results with regards to the level of calcium and no observed adverse effects. Re-dosing was required at an 8-week interval, with no adverse effects. CONCLUSIONS Pamidronate is a safe option to use in treating hypercalcemia in end-stage renal disease patients on dialysis. This can be especially beneficial in patients with sustained hypercalcemia secondary to malignancy.
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.908605