Evidence map›Paper›PMID 40710560›Full record

ReviewMetabolites2025

Fracture Risk in Chronic Kidney Disease: Addressing an Overlooked Complication.

Guido Gembillo, Concetto Sessa, Walter Morale, Luca Zanoli, Antonino Catalano, Salvatore Silipigni, Luca Soraci, Andrea Corsonello, Maria Princiotto, Carlo Lomonte and 1 more

Abstract readReview
In one paragraph

Review in Metabolites, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Guido GembilloUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.ORCID 0000-0003-4823-9910
Concetto SessaNephrology and Dialysis Department, "Maggiore" Hospital, Modica, 97100 Ragusa, Italy.
Walter MoraleNephrology and Dialysis Department, "Maggiore" Hospital, Modica, 97100 Ragusa, Italy.
Luca ZanoliDepartment of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy.
Antonino CatalanoUnit and School of Geriatrics, Department of Clinical and Experimental Medicine, University Hospital of Messina, Via C. Valeria, 98125 Messina, Italy.ORCID 0000-0003-3890-2299
Salvatore SilipigniDepartment of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98100 Messina, Italy.ORCID 0000-0002-3033-9713
Luca SoraciUnit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, Italy.ORCID 0000-0002-0171-3358
Andrea CorsonelloUnit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, Italy.ORCID 0000-0002-7276-3256
Maria PrinciottoLaboratory of Pharmacoepidemiology and Biostatistics, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, Italy.ORCID 0009-0003-8258-4707
Carlo LomonteU.O.C. di Nefrologia e Dialisi, Ospedale Generale "F. Miulli", 70021 Acquaviva delle Fonti, Italy.ORCID 0000-0001-6752-582X
Domenico SantoroUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.ORCID 0000-0002-4279-6559

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fracture risk is a serious yet underrecognized complication among patients with chronic kidney disease (CKD), especially in those with stages G3-G5D. The overlap between CKD-Mineral and Bone Disorder (CKD-MBD) and osteoporosis leads to complex bone changes that increase the likelihood of fragility fractures. Studies show that 18% to 32% of CKD patients also have osteoporosis, and these individuals are more than 2.5 times as likely to suffer from fractures compared to those without CKD. In the advanced stages of the disease, fracture risk is up to four times higher than in the general population, with the femur, forearm, and humerus being the most commonly affected sites. Hip fractures are of particular concern as they are linked to longer hospital stays and higher rates of morbidity and mortality. Furthermore, dialysis patients who experience hip fractures have a mortality rate 2.4 times higher than those in the general population with similar fractures. This increased risk underscores the need for proactive bone health maintenance in CKD patients to prevent fractures and related complications. This review explores the underlying pathophysiological mechanisms, diagnostic challenges, and treatment options related to bone fragility in CKD. Diagnostic tools, such as bone mineral density (BMD) assessments, the trabecular bone score (TBS), and biochemical markers, remain underused, especially in advanced CKD stages. Recent treatment strategies emphasize a multidisciplinary, stage-specific approach, incorporating calcium and vitamin D supplements, anti-resorptive agents like denosumab, and anabolic therapies such as teriparatide and romosozumab. Effective management needs to be tailored to the patient's bone turnover status and stage of CKD. Despite progress in understanding bone fragility in CKD, significant gaps remain in both diagnosis and treatment. Personalized care, guided by updated KDIGO recommendations and based on an interdisciplinary approach, is essential to reduce fracture risk and improve outcomes in this vulnerable population. Further research is needed to validate risk assessment tools and refine therapeutic protocols.

Indexed as

bone healthCKD-MBDdialysisfracture riskrenal osteodystrophy

Identifiers

PMID40710560
PMCPMC12298187

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.