Case report of hypercalcemia-related kidney complications after discontinuation of denosumab

Gerrit van den Berg; Marc R Lilien; Rutger R G Knops; Robert J J van Es; Atty T H van Dijk; Mandy G Keijzer-Veen

doi:10.3389/fped.2025.1583240

Case report of hypercalcemia-related kidney complications after discontinuation of denosumab

Gerrit van den Berg^*, Marc R Lilien, Rutger R G Knops, Robert J J van Es, Atty T H van Dijk, Mandy G Keijzer-Veen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The use of the osteoclastogenesis inhibitor denosumab is increasing in pediatrics, especially in the treatment of giant cell tumor or granuloma of bone or jaw, aneurysmal bone cyst, and other rare bone disorders. Particularly in pediatric patients, adverse kidney effects-such as acute kidney injury (AKI), hypertension, and nephrocalcinosis-are a significant concern that has received little attention.

CASE-DIAGNOSIS/TREATMENT: In this report, we present three children who developed hypercalcemia-related AKI six months after discontinuation of denosumab treatment. Treatment of the hypercalcemia consisted of hyperhydration, and administration of furosemide, denosumab or bisphosphonate.

CONCLUSIONS: Clinicians should be aware of the side effects of denosumab for at least seven months after discontinuation of denosumab. Early diagnosis and prompt management of hypercalcemia will result in recovery of AKI, however long-term consequences cannot be ruled out.

Original language	English
Article number	1583240
Number of pages	6
Journal	Frontiers in Pediatrics
Volume	13
DOIs	https://doi.org/10.3389/fped.2025.1583240
Publication status	Published - 6 Jun 2025

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Case report of hypercalcemia-related kidney complications after discontinuation of denosumabFinal published version, 386 KBLicence: CC BY

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title = "Case report of hypercalcemia-related kidney complications after discontinuation of denosumab",

abstract = "BACKGROUND: The use of the osteoclastogenesis inhibitor denosumab is increasing in pediatrics, especially in the treatment of giant cell tumor or granuloma of bone or jaw, aneurysmal bone cyst, and other rare bone disorders. Particularly in pediatric patients, adverse kidney effects-such as acute kidney injury (AKI), hypertension, and nephrocalcinosis-are a significant concern that has received little attention.CASE-DIAGNOSIS/TREATMENT: In this report, we present three children who developed hypercalcemia-related AKI six months after discontinuation of denosumab treatment. Treatment of the hypercalcemia consisted of hyperhydration, and administration of furosemide, denosumab or bisphosphonate.CONCLUSIONS: Clinicians should be aware of the side effects of denosumab for at least seven months after discontinuation of denosumab. Early diagnosis and prompt management of hypercalcemia will result in recovery of AKI, however long-term consequences cannot be ruled out.",

author = "{van den Berg}, Gerrit and Lilien, {Marc R} and Knops, {Rutger R G} and {van Es}, {Robert J J} and {van Dijk}, {Atty T H} and Keijzer-Veen, {Mandy G}",

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doi = "10.3389/fped.2025.1583240",

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T1 - Case report of hypercalcemia-related kidney complications after discontinuation of denosumab

AU - van den Berg, Gerrit

AU - Lilien, Marc R

AU - Knops, Rutger R G

AU - van Es, Robert J J

AU - van Dijk, Atty T H

AU - Keijzer-Veen, Mandy G

PY - 2025/6/6

Y1 - 2025/6/6

N2 - BACKGROUND: The use of the osteoclastogenesis inhibitor denosumab is increasing in pediatrics, especially in the treatment of giant cell tumor or granuloma of bone or jaw, aneurysmal bone cyst, and other rare bone disorders. Particularly in pediatric patients, adverse kidney effects-such as acute kidney injury (AKI), hypertension, and nephrocalcinosis-are a significant concern that has received little attention.CASE-DIAGNOSIS/TREATMENT: In this report, we present three children who developed hypercalcemia-related AKI six months after discontinuation of denosumab treatment. Treatment of the hypercalcemia consisted of hyperhydration, and administration of furosemide, denosumab or bisphosphonate.CONCLUSIONS: Clinicians should be aware of the side effects of denosumab for at least seven months after discontinuation of denosumab. Early diagnosis and prompt management of hypercalcemia will result in recovery of AKI, however long-term consequences cannot be ruled out.

AB - BACKGROUND: The use of the osteoclastogenesis inhibitor denosumab is increasing in pediatrics, especially in the treatment of giant cell tumor or granuloma of bone or jaw, aneurysmal bone cyst, and other rare bone disorders. Particularly in pediatric patients, adverse kidney effects-such as acute kidney injury (AKI), hypertension, and nephrocalcinosis-are a significant concern that has received little attention.CASE-DIAGNOSIS/TREATMENT: In this report, we present three children who developed hypercalcemia-related AKI six months after discontinuation of denosumab treatment. Treatment of the hypercalcemia consisted of hyperhydration, and administration of furosemide, denosumab or bisphosphonate.CONCLUSIONS: Clinicians should be aware of the side effects of denosumab for at least seven months after discontinuation of denosumab. Early diagnosis and prompt management of hypercalcemia will result in recovery of AKI, however long-term consequences cannot be ruled out.

U2 - 10.3389/fped.2025.1583240

DO - 10.3389/fped.2025.1583240

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SN - 2296-2360

VL - 13

JO - Frontiers in Pediatrics

JF - Frontiers in Pediatrics

M1 - 1583240

ER -

Case report of hypercalcemia-related kidney complications after discontinuation of denosumab

Abstract

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