Takeaway
Bisphosphonate use was associated with a modest increase in the risk of chronic kidney disease (CKD) progression in patients with moderate-to-severe CKD (stage IIIb-V).
No association was seen between bisphosphonate use and acute kidney injury, gastrointestinal (GI) events or hypocalcaemia.
Why this matters
Bisphosphonates, which are currently contraindicated or used with caution in patients with an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m2 should continue to be used with caution in this population.
Study design
This study included patients with moderate-to-severe CKD (eGFR <45 mL/min/1.73m2; age, ≥40 years) from the UK Clinical Practice Research Datalink (CPRD; 1997-2016) and Catalonia’s Information System for the Development of Research in Primary Care (SIDIAP; 2007-2015).
2447 bisphosphonate users were propensity score matched with 8931 non-users from CPRD and 1399 users with 6547 non-users from SIDIAP.
Primary outcome: CKD stage worsening.
Funding: National Institute of Health Research Health Technology.
Key results
Bisphosphonate use was associated with an increased risk of CKD progression in CPRD (HR, 1.14; 95% CI, 1.04-1.26) and SIDIAP (HR, 1.15; 95% CI, 1.04-1.27); combined HR, 1.14; 95% CI, 1.07-1.23.
No risk differences were observed for:
acute kidney injury (combined HR, 0.92; 95% CI, 0.78-1.08);
GI bleeding/ulcers (combined HR, 0.97; 95% CI, 0.70-1.33); and
hypocalcaemia (HR, 0.34; 95% CI, 0.08-1.43) in CPRD.
Limitations
Risk of confounding.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
© 2021 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Safety of Oral Bisphosphonates in Patients With Moderate-to-severe CKD - Medscape - Feb 04, 2021.
Comments