 Zoledronate 4 mg will be infused in 100 ml NSaline over 15 minutes in patients with a creatinine level 1.5 times the upper limit of the normal range i.e 165 μmolL. Patients with renal impairment as indicated by a serum creatinine level 1.5 x ULN will be discussed on an individual basis with the Medical Adviser of Novartis. If zoledronate is to be given, an extended infusion time may be used. Renal toxicity has been reported with rapid infusions 5 min of 8 mg of zoledronate in patients with pre-existing renal failure. Further pharmacokinetic studies in patients with renal failure are being undertaken by Novartis to clarify this area. Zoledronate infusion should be freshly prepared and administered without delay. 