Abnormal bone metabolism is closely associated and described in the chronic kidney disease-mineral bone disorder (CKD-MBD). The very high risk of osteoporotic fractures (and associated mortality) demonstrated in patients with CKD has re-attracted the interests of nephrologists to assess bone disorders periodically.

Numerous guidelines recommend prompt action to be taken for fracture risk assessment, diagnosis and treatment of osteoporosis in the context of CKD and CKD-MBD, even beyond renal osteodystrophy. 

A non-invasive approach to assess bone disorders in order to guide treatment decisions for controlling CKD-MBD and decreasing the risk of fracture is important. Use of biomarkers such as parathyroid hormone, alkaline phosphatases, and other biochemical markers of bone activity can serve as alternatives to some aspects of bone histomorphometry, as they have been proven promising clinically.

The classic and new imaging techniques for assessing bone disorders can also be utilized for CKD patients. Updated information in this regard is necessary for increasing the Quality of life in CKD patients.

Source-Bover, J., Ureña-Torres, P., Cozzolino, M. et al. The Non-invasive Diagnosis of Bone Disorders in CKD. Calcif Tissue Int 108, 512–527 (2021). https://doi.org/10.1007/s00223-020-00781-5