ClinicalTrials.gg
Not yet recruitingNCT07741136ZADIALUpdated Sep 10, 2026

Pharmacokinetics of Zoledronic Acid in Patients on Dialysis

A Phase 1 interventional study of Zoledronic Acid Injection, 5.0 mg, single dose and Zoledronic Acid Injection, 2.5 mg, single dose in Chronic Kidney Disease, Osteoporosis and Dialysis, sponsored by University of Campinas, Brazil. Not yet recruiting at 1 site in Brazil. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by University of Campinas, Brazil · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
24
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Osteoporosis is a frequent complication of chronic kidney disease (CKD) on dialysis, with an estimated prevalence of approximately 40%. It is associated with increased fracture risk, reduced quality of life, and higher mortality. Despite available therapies, management often remains suboptimal, partly due to limited evidence on the safety and pharmacokinetics of bisphosphonates in this population. Objectives: To understand the pharmacokinetics of zoledronic acid in CKD patients on dialysis, as well as to analyze its effects on biomarkers of bone metabolism, bone mineral density (BMD), and clinical outcomes. Materials and Methods: This prospective clinical study involves 24 adult individuals, 8 with CKD-associated osteoporosis (control group; estimated glomerular filtration rate (eGFR) ≥ 35 mL/min/1.73 m²) and 16 with CKD-associated osteoporosis anuric on dialysis patients. Individuals undergoing dialysis will be assigned to receive zoledronic acid at doses of 2.5 mg or 5 mg intravenously (single dose, at the beggining of dialysis session), while patients with CKD-associated osteoporosis (control group; estimated glomerular filtration rate (eGFR) ≥ 35 mL/min/1.73 m²) will receive 5 mg, also in a single dose. Serial blood samples will be collected after infusion, during dialysis session and again up to 96h after dialysis session initiation. The dialysate will be continuously sampled in a tank and aliquots collected for further analysis. The plasma levels of zoledronic acid will be calculated from blood and dialysate samples using liquid chromatography mass spectrometry. The primary outcome is the plasma concentration-time curve of zoledronic acid during a regular dialysis session. Secondary outcomes are: (i) plasma concentration of zoledronic acid up to 96h;(ii) the total mass of zoledronic acid extracted by the dialysate; (iii) the dialytic clearance of zoledronic acid. Evaluation of bone biomarkers (e.g., PTH, alkaline phosphatase, calcium, phosphorus, CTX, and P1NP) and BMD (assessed by bone densitometry) will be performed at baseline and at 12 months. The study will be conducted at the UNICAMP Clinical Hospital, with the participation of one participating center, subject to prior approval from the respective Research Ethics Committees. All participants will be included only after signing the Informed Consent Form. Data will be anonymized and processed in accordance with the General Data Protection Law (LGPD). Expected results: To characterize the pharmacokinetic profile and establish the best dosage regimen of zoledronic acid in patients with CKD on dialysis; to observe the impact of the drug on biomarkers of bone metabolism and BMD.

02

Conditions studied

  • Chronic Kidney Disease
  • Osteoporosis
  • Dialysis

Keywords

  • Zoledronic acid
  • bisphosphonate
  • Dialysis
  • Pharmacokinetics
  • Osteoporosis
03

In context

Renal Insufficiency, Chronic

3,090 studies on the registry are indexed under Renal Insufficiency, Chronic; 698 are open to participants now.

This study's planned enrollment of 24 is below the median of 73 across 2,157 interventional studies indexed under Renal Insufficiency, Chronic.

Browse Renal Insufficiency, Chronic studies →

Lead sponsor

University of Campinas, Brazil is the lead sponsor of 168 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Individuals aged 18 years or older, with CKD-associated osteoporosis
  • ≥ 35 mL/min/1.73 m2 and advanced CKD on dialysis
  • Agree to participate in the research by signing the form

Exclusion criteria

Exclusion Criteria:

  • Individuals under 18 years of age, pregnant or breastfeeding women
  • Patients with CKD with hypocalcemia/hypophsphatemia
  • Patients with CKD on dialysis with residual diuresis > 100 mL/24h*
  • Patients with CKD on low-flux membrane dialysis*
  • Patients with neoplasia
  • to bisphosphonates, or previous use of the medication
  • Inadequate oral condition or anticipated invasive dental procedure within the next 12 months
  • Alkaline phosphatase \< 98 IU/L or > 180 IU/L*
  • PTH \< 130 pg/mL and > 585 pg/mL*
  • CTX \< Lower Limit of Normal (LLN) or
  • CTX \< Upper Reference Limit (URL)*
  • Severe liver disease
  • Severe heart disease
  • Clinical suspiction of osteomalacia or adynamic bone disease
  • Cytopenias, defined as: \< 120,000/mm³, neutrophils \< 3,000/mm³, lymphocytes \< 1,000/mm³ and hematocrit \< 26% * Applicable only to the group of patients undergoing dialysis.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
24 participants (estimated)

Study arms

  • Active comparator
    Control group

    CKD-associated osteoporosis in patients with eGFR \>= 35 mL/min, allocated to receive conventional dose (5 mg, single dose).

    Drug: Zoledronic Acid Injection, 5.0 mg, single dose

  • Experimental
    CKD_Dialysis_2.5

    CKD-associated osteoporosis in patients on dialysis, allocated to receive reduced dose (2.5 mg, single dose), at the beginning of dialysis session.

    Drug: Zoledronic Acid Injection, 2.5 mg, single dose

  • Experimental
    CKD_Dialysis_5.0

    CKD-associated osteoporosis in patients on dialysis, allocated to receive conventional dose (5 mg, single dose), at the beginning of dialysis session.

    Drug: Zoledronic Acid Injection, 5.0 mg, single dose

Interventions

  • DrugZoledronic Acid Injection, 5.0 mg, single dose

    Zoledronic Acid Injection, 5.0 mg, single dose for patients with CKD-associated osteoporosis with eGFR \>= 35 mL/min.

  • DrugZoledronic Acid Injection, 2.5 mg, single dose

    Zoledronic Acid Injection, 2.5 mg, single dose, for patients with CKD-associated osteoporosis on dialysis, at the beginning of dialysis session.

  • DrugZoledronic Acid Injection, 5.0 mg, single dose

    Zoledronic Acid Injection, 5.0 mg, single dose, for patients with CKD-associated osteoporosis on dialysis, at the beginning of dialysis session.

06

What researchers measure

Primary outcomes

  1. Area Under the Curve of zoledronic acid (ng.mL/mL)

    Area under the curve of the plasma concentration-time curve of zoledronic acid

    Time frame: From the start of dialysis session to ninety six hours (96 hours) post- drug administration.

Secondary outcomes

  1. Total mass of zoledronic acid extracted by the dialysis

    Zoledronic acid mass (mg)

    Time frame: From the dialysis session start to the end of session at four hours (4h)

07

Study locations

1 site
  • School of Medical Sciences, University of Campinas
    Campinas, São Paulo 13083-887, Brazil
    • Rodrigo B de Oliveira, PhD · Contactrbo@unicamp.br · +55 19 35217366
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07741136
Collaborators
São Paulo State University
Responsible party
Rodrigo Bueno de Oliveira (Principal Investigator, University of Campinas, Brazil) — Principal investigator
First posted
Aug 3, 2026
Start date
Aug 15, 2026 (estimated)
Primary completion
Aug 15, 2027 (estimated)
Completion
Aug 15, 2028 (estimated)
Last update
Sep 10, 2026

Study contacts

Rodrigo B de Oliveira, PhD
Contact
rbo@unicamp.br
+55 19 35217366
Maria E. Bueno, M.D.
Contact
madu_bueno@hotmail.com
+55 15 981563600
Rodrigo B de Oliveira, PhD
principal investigator · University of Campinas

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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