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NDT Advance Access originally published online on May 25, 2007
Nephrology Dialysis Transplantation 2007 22(8):2366-2370; doi:10.1093/ndt/gfm209
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Focal segmental glomerulosclerosis associated with long-term treatment with zoledronate in a myeloma patient

Michael Bodmer1,2, Patrizia Amico3, Michael J. Mihatsch4, Manuel Haschke1, Oliver Kummer1, Stephan Krähenbühl1 and Michael Mayr3

1Department of Clinical Pharmacology and Toxicology, 2Division of Internal Medicine, 3Clinic for Transplantation Immunology and Nephrology and 4Department of Pathology, University Hospital Basel, 4031 Basel, Switzerland

Correspondence and offprint requests to: Michael Bodmer, MD, MSc, Department of Clinical Pharmacology and Toxicology and Division of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland. Email: bodmerm@uhbs.ch

Keywords: bisphosphonates; collapsing glomerulopathy; focal segmental glomerulosclerosis; pamidronate; renal failure; zoledronate

The first 150 words of the full text of this article appear below.



   Introduction
 
Bisphosphonates were designed as synthetic analogues of endogenous pyrophosphate, which act as a regulator of bone metabolism and is found abundantly in bone matrix [1,2]. Non-nitrogen containing first-generation bisphosphonates, such as clodronate or etidronate, which closely resemble pyrophosphate, primarily induce osteoclast apoptosis by intracellular accumulation of non-hydrolyzable ATP analogues [3]. Nitrogen-containing bisphosphonates, such as zoledronate, pamidronate, ibandronate and alendronate, have been found to act on bone-resorbing osteoclasts by inhibiting farnesyldiphosphate (FPP) synthase, a key regulatory enzyme in the mevalonate pathway. Inhibition of FPP synthase prevents post-translational prenylation of small GTPases, causing impaired osteoclast function and sensitizing cells for apoptosis [4–6].

To date, zoledronate is one of the most potent bisphosphonates with very high affinity to bone [7]. It is in widespread use for the treatment of patients with multiple myeloma or bone metastasis due to solid tumours as well as . . . [Full Text of this Article]



   Case
 


   Discussion
 

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