Alendronate associated focal segmental glomerulosclerosis: a case report and review of the literature

Although kidney injury associated with intravenous bisphosphonate therapy is well documented, there are very few reported instances of oral bisphosphonate therapy leading to focal segmental glomerulosclerosis (FSGS) and kidney failure. We report the case of a 79-year-old woman who developed acute kidney injury due to collapsing FSGS while receiving therapy with weekly oral alendronate therapy for osteoporosis. Withdrawal of alendronate and treatment with corticosteroids resulted in partial recovery of kidney function for a period of 16 months until she developed progressive kidney failure needing long-term dialysis. This case report and the literature review highlight the fact that oral bisphosphonates may be associated with a risk of developing FSGS.