ReviewJournal of clinical medicine2025
The Conundrum of Medical Fracture Prevention in Chronic Kidney Disease-Summary of the Evidence and Pragmatic Clinical Guidance.
Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Calcimimetics and CaSR signaling in CKD-MBD: bone-immune-vascular crosstalk and therapeutic potential.Frontiers in immunology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fragility fractures are a major complication in chronic kidney disease (CKD), yet therapeutic strategies for their prevention remain highly controversial. The unique pathophysiology of CKD-mineral and bone disorder (CKD-MBD), coupled with the paucity of dedicated clinical trials, create substantial uncertainty regarding the efficacy and safety of medical interventions established in the general osteoporosis population. This review summarizes the available evidence regarding fracture risk and bone mineral density including pragmatic clinical guidance for the use of calcium, vitamin D, phosphate binders, calcimimetics, bisphosphonates, denosumab, romosozumab, and teriparatide in patients with advanced non-dialysis CKD, on dialysis, and after kidney transplantation. For calcium, the conflicting balance between skeletal needs and risk of vascular calcification in the setting of declining kidney function and limited evidence for fracture prevention is outlined. For vitamin D, the gap between its widespread clinical use and the inconsistent data on fracture prevention is analyzed including a discussion of target levels in progressive kidney dysfunction. For phosphate binders, the evidence for fracture prevention, showing benefits in dialysis populations, is summarized together with a synthesis of data on potential risks of calcium-based agents. For calcimimetics, the available evidence on their role in fracture prevention, PTH, and calcium control is reviewed. For bisphosphonates, the unresolved question of benefit versus harm in advanced CKD stages are discussed and the evidence regarding efficacy and safety for various clinical settings is disentangled. For denosumab, the current data on fracture prevention is presented with emphasis on its renal-independent pharmacokinetics and strategies to mitigate hypocalcemia and rebound fracture risk. For romosozumab, the promising effects on bone health are reviewed alongside an analysis of cardiovascular safety data. For teriparatide, the limited evidence in patients with low bone turnover disease is evaluated. The review navigates the available evidence and unresolved controversies across therapeutic options, and provides pragmatic guidance to support individualized clinical decision-making.
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