PMC3914195_01
Light microscopy renal biopsy results (H&E stain). Renal biopsy showing changes of ATN. (a) Proximal tubules are mildly dilated and simplified in appearance. Scattered tubules contain denuded and necrotic epithelial cells (arrows). Patchy very mild interstitial inflammation is seen in the right upper-hand corner. Glomeruli (G) exhibit only mild mesangial prominence; art: distal artery (H&E stain, original magnification = 100x). (b) Higher magnification reveals attenuation of proximal tubular epithelium with loss or disruption of brush border. The interstitium exhibits edema superimposed upon mild fibrosis (H&E stain, original magnification = 400x).
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fig1
The tubulointerstitium exhibited signs of acute tubular necrosis (ATN) (Figure 1).
Evolution of serum creatinine in relation to injections of Zoledronic acid.
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fig2
Interestingly, and despite her extensive bone metastases, she never developed hypercalcemia.  Figure 2 summarizes the evolution of SCr levels before and after injection of Zoledronic acid from 2005 to 2009, and Table 1 shows the other biological measurements.