Review ArticleDenosumab-Associated Severe Hypocalcemia in a Patient with Chronic Kidney Disease: Case Report and Review of Literature

Denosumab is a monoclonal antibody directed against the receptor activator of nuclear factor kappa B ligand (RANKL). Denosumab has been shown to reduce the risk of skeletal-related events, including spinal cord compression, pathologic fracture and hypercalcemia of malignancy in patients with bone metastases. Hypocalcemia is a known side effect of denosumab, occurring in an estimated 8–14% of the patients. Here we present an asymptomatic patient with stage-5 chronic kidney disease and severe hypocalcemia who had received denosumab one month earlier.