Global and regional prevalence of osteopenia in chronic kidney disease: a systematic review and meta-analysis

The global prevalence of osteopenia among people with chronic kidney disease (CKD) remains uncertain. This research aimed to estimate the global and regional prevalence of osteopenia in CKD patients. Databases including PubMed, Scopus, Science Direct, Web of Science, and Embase, along with Google Scholar engine, were explored from January 1, 2000, to January 1, 2025, in English. The eligibility criteria included adults (≥ 18 years) with CKD stages 3a-5D. The risk of bias assessment performed using the Joanna Briggs Institute (JBI) checklist. The I-square index was employed to assess heterogeneity, whereas publication bias was evaluated through Egger's test and funnel plots. Statistical analyses were performed using Stata software Version 17. The prevalence of femoral neck osteopenia in CKDs estimated 47% (95% CI: 43 to 50, n = 45). The lumbar spine osteopenia estimated 35% (95% CI: 33 to 37, n = 52). Based on specific bone site, the osteopenia prevalence is 40% (95% CI: 35 to 45, n = 24) in total hip, 28% (95% CI: 19 to 38, n = 5) in forearm, and 31% (95% CI: 24 to 37, n = 9) in distal radius. The sex-specific rate is 37% (95% CI: 32 to 42, n = 30) for men and 36% (95% CI: 31 to 41, n = 30) for women. Our study uncovered a significant prevalence of osteopenia in CKD patients stages 3a-5D, with the highest rate in bone areas abundant in cortical content (femoral neck region).