A consensus statement on the management of vertebral fractures in CKD stages G4–G5D

Abstract

Skeletal fragility has long been overlooked by the nephrology community despite patients with chronic kidney disease (CKD) facing double the risk of hip fracture compared with the general population. Consequently, the term CKD-associated osteoporosis was recently coined to increase awareness. In this context, vertebral fractures are even less studied. Vertebral fractures predict increased fracture risk, and especially in advanced CKD, show a strong association with aortic and iliac vascular calcifications and cardiovascular events such as myocardial infarction. The scope of the present consensus paper is to comprehensively discuss the management of skeletal fragility in CKD patients, from diagnosis to treatment, with a particular focus on vertebral fractures in CKD G4–G5D.

Metadata

Item Type:	Article
Authors/Creators:	Fusaro, M. https://orcid.org/0000-0001-9478-4851 Chandran, M. Nickolas, T. https://orcid.org/0000-0001-8870-1896 Ferrari, S. https://orcid.org/0000-0002-1372-4417 Cossettini, A. Ebeling, P.R. https://orcid.org/0000-0002-2921-3742 Mc Closkey, E. https://orcid.org/0000-0003-0177-8140 Harvey, N. https://orcid.org/0000-0002-8194-2512 Pierroz, D.D. Cannata-Andia, J. Cheung, A. Guglielmi, G. Glüer, C. Foldes, J. Lems, W. Trombetti, A. Mithal, A. Napoli, N. Haarhaus, M. https://orcid.org/0000-0001-8274-6356 Ferraro, P.M. https://orcid.org/0000-0002-1379-022X Ketteler, M. Bellasi, A. Moyses, R. Evenepoel, P. https://orcid.org/0000-0002-0797-4321 Jørgensen, H.S. https://orcid.org/0000-0002-0881-2615 Reginster, J.-Y. Halbout, P. Bover, J. Gallieni, M. https://orcid.org/0000-0002-2011-2160 Salam, S. https://orcid.org/0000-0001-9236-3906 Eastell, R. https://orcid.org/0000-0002-0323-3366 Hansen, D. https://orcid.org/0000-0003-4929-7901 E, C. https://orcid.org/0000-0003-0947-2226 Brandi, M.L.
Copyright, Publisher and Additional Information:	© The Author(s) 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords:	CKD-MBD; bone mineral density; chronic renal insufficiency; skeletal fragility; treatment; vertebral fractures
Dates:	Submitted: 27 September 2025 Accepted: 13 November 2025 Published (online): 28 November 2025 Published: 28 November 2025
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health
Date Deposited:	21 Jan 2026 16:45
Last Modified:	21 Jan 2026 16:45
Status:	Published online
Publisher:	Oxford University Press (OUP)
Refereed:	Yes
Identification Number:	10.1093/ndt/gfaf256
Related URLs:	PubMed URL
Sustainable Development Goals:
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:236770

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A consensus statement on the management of vertebral fractures in CKD stages G4–G5D

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