Evidence map›Paper›PMID 42239793›Full record

ArticleResearch square2026

Renal Outcomes and Dosage Considerations Associated with Bisphosphonate Use: A Systematic Review of Randomized Clinical Trials.

Prajith Venkatasubramanian, Reshma Raju, Pratheeksha Sojan Biatris, Sam Johnson Udaya Chander

Abstract readPreprint
In one paragraph

Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Prajith VenkatasubramanianCentre of Excellence for Long-acting Therapeutics, University of Liverpool, United Kingdom.ORCID 0009-0005-6867-9413
Reshma RajuDepartment of Health Informatics, Rutgers University, Piscataway, United States of America.
Pratheeksha Sojan BiatrisOrange Pharmacy LLC, Sharjah, United Arab Emirates.
Sam Johnson Udaya ChanderDepartment of Pharmacy Practice, College of Pharmacy, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, Tamil Nadu, India.

Funding

The Long-Acting/Extended Release Antiretroviral Resource Program (LEAP)R24AI118397 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Charles W. Flexner · 2015 to 2026
$9.4M
NIAID NIH HHS R24 AI118397
6 · The paper itself

Abstract

Background: Though bisphosphonates are the gold standard for the treatment of different metabolic bone disorders including osteoporosis for more than five decades, their safety and tolerability in patients with compromised kidney function are not well known. With age-related bone disorders and renal insufficiency becoming more prevalent worldwide, understanding the effect of bisphosphonates on patients with compromised renal function becomes inevitable. This review aims to analyze the clinical data available on safety of bisphosphonates on patients with different levels of renal function. Methods: A broad search of PubMed, Wiley Online and the Cochrane Central Register of Controlled Trials was conducted to select randomized controlled trials and clinical trials that evaluated the safety and tolerability of bisphosphonate in patients with different levels of renal function between 2000 and 2026. Results: Out of 1388 titles and abstract reviewed, 17 articles were included in the final analysis using PRISMA 2020 guidelines. Despite one trial showing < 2% increase in serum creatinine from baseline, all the other trials proved that bisphosphonates are safe and well tolerated by the patients with transplanted kidney and with compromised kidney function. Meta analysis of the data provided from eligible clinical trials using RStudio indicated that the proportion of serum creatinine that is increased was < 25% from baseline. Further, random effects model (100% (-0.01)) was performed due to high level of heterogeneity and it indicated that ibandronate 27.93%; alendronate 28.58%; risedronate 27.80% and zoledronate 15.69%. The pooled effect shows that kidney damage by bisphosphonates is not statistically significant. Conclusion: The evidence from this review suggests that the bisphosphonates are generally well-tolerated with ten trials registering no drug-related withdrawals and other studies showing only very negligible withdrawals due to adverse effects. Even though bisphosphonates are safer to use in compromised renal function i.e., > 30ml/min/1.73m

Indexed as

alendronateBisphosphonatesibandronateosteoporosisrandomized controlled trialsrenal insufficiencyrenal safetyrenal toxicityrisedronatesafetytolerabilityzoledronic acid

Identifiers

PMID42239793
PMCPMC13228822

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.