Vidal Sarah A, Skorupski Katherine A, Willcox Jennifer L, Palm Carrie A, Burton Jenna H
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
Front Vet Sci. 2021 Jul 2;8:647846. doi: 10.3389/fvets.2021.647846. eCollection 2021.
Zoledronic acid (ZOL) is an intravenous bisphosphonate indicated for the use of hypercalcemia of malignancy and management of bony metastases. Its therapeutic effect lies in the targeting of malignant osteoclasts; however, administration can be associated with renal toxicity. The objective of this retrospective study was to evaluate the frequency and severity of acute kidney injury (AKI) following ZOL administration in a cohort of cancer-bearing dogs. A pharmacy search was conducted to identify dogs that received a dose of ZOL between June 2016 and July 2019. Inclusion criteria included baseline and post-treatment chemistry panels. Medical records were reviewed to obtain clinical data including signalment, dose, dosage, number of treatments administered, and changes in renal function. Forty-four dogs met the inclusion criteria. Median number of doses administered was three [interquartile range (IQR), 2-5]. The median highest creatinine value occurred after a median of one dose (IQR, 1-2 doses) compared with the median highest value of blood urea nitrogen, phosphorus, and potassium, which occurred after a median of two doses (IQR, 1-3). Six (13.6%) dogs developed an AKI, and one dog (2.3%) had progression of an existing azotemia after treatment with ZOL was initiated. Two dogs (4.5%) had ZOL treatment discontinued secondary to development of azotemia. Use of concurrent administration of non-steroidal anti-inflammatory drugs or anesthesia did not significantly increase the risk of AKI in this cohort of dogs. Acute kidney injury is observed infrequently in cancer-bearing dogs treated with ZOL and is generally mild to moderate in severity; discontinuation of ZOL due to AKI is uncommon.
唑来膦酸（ZOL）是一种静脉注射用双膦酸盐，用于治疗恶性肿瘤引起的高钙血症和管理骨转移。其治疗效果在于靶向恶性破骨细胞；然而，给药可能与肾毒性有关。这项回顾性研究的目的是评估一组患癌犬接受ZOL治疗后急性肾损伤（AKI）的发生频率和严重程度。进行了药房检索，以确定在2016年6月至2019年7月期间接受一剂ZOL的犬只。纳入标准包括基线和治疗后的血液生化指标。查阅医疗记录以获取临床数据，包括特征、剂量、给药次数、给予的治疗次数以及肾功能变化。44只犬符合纳入标准。给药剂量的中位数为3次[四分位数间距（IQR），2 - 5次]。肌酐最高值的中位数出现在一剂的中位数之后（IQR，1 - 2剂），而血尿素氮、磷和钾的最高值中位数出现在两剂的中位数之后（IQR，1 - 3剂）。6只（13.6%）犬发生了AKI，1只犬（2.3%）在开始ZOL治疗后现有氮质血症有所进展。2只犬（4.5%）因氮质血症的发生而停用ZOL。在这组犬中，同时使用非甾体抗炎药或麻醉并未显著增加AKI的风险。在用ZOL治疗的患癌犬中，急性肾损伤很少见，且严重程度一般为轻至中度；因AKI停用ZOL的情况并不常见。
