Miura Naoto, Mizuno Natsuko, Aoyama Ryuhei, Kitagawa Wataru, Yamada Harutaka, Nishikawa Kazuhiro, Imai Hirokazu
Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.
Clin Exp Nephrol. 2009 Feb;13(1):85-8. doi: 10.1007/s10157-008-0078-x. Epub 2008 Aug 28.
A 61-year-old Japanese man with nephrotic syndrome due to focal segmental glomerulosclerosis was initially responding well to steroid therapy. The amount of daily urinary protein decreased from 15.6 to 2.8 g. Within 14 days of the oral bisphosphonate (alendronate sodium) administration, the amount of daily urinary protein increased rapidly up to 12.8 g with acute renal failure. After discontinuing the oral alendronate, the patient underwent six cycles of hemodialysis and four cycles of LDL apheresis. Urinary volume and serum creatinine levels recovered to the normal range, with urinary protein disappearing completely within 40 days. This report demonstrates that not only intravenous, but also oral bisphosphonates can aggravate proteinuria and acute renal failure.
一名61岁因局灶节段性肾小球硬化导致肾病综合征的日本男性，最初对类固醇治疗反应良好。每日尿蛋白量从15.6克降至2.8克。在口服双膦酸盐（阿仑膦酸钠）14天内，每日尿蛋白量迅速增加至12.8克，并伴有急性肾衰竭。停用口服阿仑膦酸盐后，患者接受了6个周期的血液透析和4个周期的低密度脂蛋白去除术。尿量和血清肌酐水平恢复到正常范围，尿蛋白在40天内完全消失。本报告表明，不仅静脉注射双膦酸盐，口服双膦酸盐也可加重蛋白尿和急性肾衰竭。
