Complications

Complication
Timeframe
Likelihood
short term
low

Potential adverse effects associated with intravenous bisphosphonate therapy include transient flu-like syndrome with aches/chills/fever.[36][35][37]

variable
low

Hypercalcaemia can lead to renal vasoconstriction, volume depletion, and a subsequent reversible decrease in glomerular filtration rate. Long-standing hypercalcaemia and hypercalciuria can lead to calcification, degeneration, and renal tubular atrophy/necrosis.[35] In addition, intravenous bisphosphonate therapy can be associated with acute kidney injury.[36][35][37]

variable
low

Hypercalcaemia is associated with neuropsychiatric symptoms, of which coma is a serious complication.

variable
low

Hypercalcaemia may lead to calcium deposition in the pancreatic duct, and to activation of trypsinogen in the pancreatic parenchyma, leading to pancreatitis. Incidence of acute pancreatitis associated with malignancy-associated hypercalcaemia is unknown.[38]

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