
A study in Japan investigated the safety of bisphosphonates (BPs) in osteoporosis patients with decreased kidney function. Analyzing real-world data, the study included 14,551 patients. Patients with mild, moderate, and severe kidney function impairment showed increased hazard ratios for hypocalcemia compared to those with normal kidney function. This risk persisted across specific BP medications. Sensitivity analysis corroborated these findings. The study highlights a heightened risk of hypocalcemia in BP users with impaired kidney function, particularly in severe cases. Consequently, the study's evidence prompted regulatory action in Japan, leading to revised package insert information emphasizing the association between hypocalcemia risk and decreased kidney function, aiming to enhance appropriate BP use with effective risk management in clinical settings.
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