This warning is based on studies on rats

To minimize the lasix purchase risk of chronic kidney disease (CKD) progresses to end-stage renal failure (CRF), drugs such as osteoporosis Alendronate (fosamaks) and ibandronat (Boniva) are contraindicated to persons whose glomerular filtration rate (SKF) is 30%. But is it safe to restart these drugs once a stage 5 CKD (or dialysis) has been achieved? - Jason Tiede, Pennsylvania, Edmond, Oklahoma 


FDA currently warns against the use of bisphosphonates in patients with SKF 30 ml/hv/1. 73 m2, which includes patients with stage 3, 4 or 5 CKD. This warning is based on studies on rats who were given rapid high dose, which resulted in histological changes and acute kidney damage. Several subsequent large studies suggest that the absence of secondary causes of low bone mineral density (IPC), the use of recommended doses of bisphosphonates in patients with age stages 2, 3 or 4 CPU may not be as nephrotoxic believed. In addition, a large trial using ibandronat in dialysis patients (stage 5) showed significant improvement in the IPC. Less assessments Alendronate in dialysis patients as a result of stabilization of hip density in patients with alendronate, and who received placebo showed worsening ABOUT. However, current FDA recommendations have not been reviewed. For more information on the latest data on the subject of unresolved cm Am J Kidney Disease. 2010, 55:941-956. - Claire Bebkok O'Connell, MPH, PA-C (159-5)