Hypercalcemia and acute kidney injury induced by eldecalcitol in patients with osteoporosis: a case series of 32 patients at a single facility

摘要

Background: Eldecalcitol (ELD) is an active vitamin D3 analog that is widely used in Japan forthe treatment of osteoporosis. The most common adverse drug reaction of ELD is hypercalcemia.However, few reports have focused on acute kidney injury (AKI) associated with ELD-inducedhypercalcemia.Materials and methods: We retrospectively reviewed the medical records at our hospital forcases of hypercalcemia-induced AKI between April 2013 and February 2018. Among them, wefocused on patients who developed AKI secondary to ELD-induced hypercalcemia.Results: Among 69 patients who developed hypercalcemia-induced AKI, 32 patients (46.4%)developed AKI associated with ELD-induced hypercalcemia. Their mean age was 82 ± 5 years,97% of them were female, mean corrected serum calcium level was 12.2 ± 1.5 mg/dL, serum creatininelevel was 2.5 ± 2.2 mg/dL, and estimated glomerular filtration rate was 23.9 ± 14.4 ml/min/1.73 m2 on admission. ELD administration was discontinued in all patients and some of themwere treated with hydration with or without calcitonin, which was followed by a normalizationof serum calcium level. Corrected serum calcium level on admission was significantly higher(p .05) in patients treated with magnesium oxide. Although there were no significant differences,serum calcium and creatine levels on admission tended to be higher in patients who weretreated with other drugs that affect renal hemodynamics and renal calcium metabolism thanthose not taking these drugs.Conclusions: Prescribers of ELD should regularly monitor serum calcium levels and kidney functionto prevent hypercalcemia and AKI associated with ELD and pay more attention to concomitantdrugs especially magnesium oxide.