A consensus statement on the management of vertebral fractures in CKD stages G4–G5D
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.
Authors
- Philippe Halbout (ORCID: https://orcid.org/0000-0002-8042-8095)
- Rosa Maria Affonso Moysés (ORCID: https://orcid.org/0000-0002-7902-2127)
- Maurizio Gallieni (ORCID: https://orcid.org/0000-0002-2011-2160)
- Serge Ferrari (ORCID: https://orcid.org/0000-0002-1372-4417)
- M. Ketteler
- Jorge B. Cannata‐Andía (ORCID: https://orcid.org/0000-0001-6543-9960)
- Angela M. Cheung (ORCID: https://orcid.org/0000-0001-8332-0744)
- Nicola Napoli (ORCID: https://orcid.org/0000-0002-3091-8205)
- Hanne Skou Jørgensen (ORCID: https://orcid.org/0000-0002-0881-2615)
- Eugène McCloskey (ORCID: https://orcid.org/0000-0003-0177-8140)
- Maria Fusaro (ORCID: https://orcid.org/0000-0001-9478-4851)
- Nicholas C. Harvey (ORCID: https://orcid.org/0000-0002-8194-2512)
- Ambrish Mithal (ORCID: https://orcid.org/0000-0002-0822-3212)
- Maria Luisa Brandi (ORCID: https://orcid.org/0000-0002-8741-0592)
- Dominique D. Pierroz (ORCID: https://orcid.org/0000-0002-2616-9192)
- Andrea Trombetti
- Peter R. Ebeling (ORCID: https://orcid.org/0000-0002-2921-3742)
- Étienne Cavalier (ORCID: https://orcid.org/0000-0003-0947-2226)
- Mathias Haarhaus (ORCID: https://orcid.org/0000-0001-8274-6356)
- Thomas L. Nickolas (ORCID: https://orcid.org/0000-0001-8870-1896)
- Pietro Manuel Ferraro (ORCID: https://orcid.org/0000-0002-1379-022X)
- Richard Eastell (ORCID: https://orcid.org/0000-0002-0323-3366)
- Ditte Hansen (ORCID: https://orcid.org/0000-0003-4929-7901)
- Syazrah Salam (ORCID: https://orcid.org/0000-0001-9236-3906)
- Antonio Bellasi (ORCID: https://orcid.org/0000-0001-7830-1645)
- Willem F. Lems (ORCID: https://orcid.org/0000-0002-6885-3953)
- Jordi Bover (ORCID: https://orcid.org/0000-0003-3577-2273)
- Giuseppe Guglielmi (ORCID: https://orcid.org/0000-0002-4325-8330)
- Pieter Evenepoel (ORCID: https://orcid.org/0000-0002-0797-4321)
- Manju Chandran (ORCID: https://orcid.org/0000-0001-9119-8443)
- Althea Cossettini
- J.-Y. Reginster
- Claus C. Glüer
- Joseph Foldes
Institutions
- University of Foggia (IT)
- University Health Network (CA)
- Karolinska University Hospital (SE)
- University of Padua (IT)
- Università Campus Bio-Medico (IT)
- University of Liège (BE)
- Tel Aviv University (IL)
- Universidad de Oviedo (ES)
- University of Toronto (CA)
- University of Milan (IT)
- Aarhus University (DK)
- Washington University in St. Louis (US)
- Singapore General Hospital (SG)
- Columbia University Irving Medical Center (US)
- Aalborg University Hospital (DK)
- Herlev Hospital (DK)
- King Saud University (SA)
- Aarhus University Hospital (DK)
- Health Net (US)
- University Hospital Southampton NHS Foundation Trust (GB)
- Max Healthcare (IN)
- Hochschule für Angewandte Wissenschaften Kiel (DE)
- Christian-Albrechts-Universität zu Kiel (DE)
- Luigi Sacco Hospital (IT)
- Ospedale regionale di Lugano (CH)
- Azienda Ospedaliera Universitaria Integrata Verona (IT)
- Ente Ospedaliero Cantonale (CH)
- Istituto di Fisiologia Clinica (IT)
- University Hospital of Geneva (CH)
- Amsterdam Neuroscience (NL)
- Institute for Musculoskeletal Health (AU)
- Arthritis UK (GB)
- NIHR Southampton Biomedical Research Centre (GB)
- Italian University Line (IT)
- National Research Council (RO)
- Klinikum Coburg (DE)
- Sheffield Kidney Institute (GB)
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (ES)
- Campus Bio Medico University Hospital (IT)
- Bone Health and Osteoporosis Foundation (US)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- MRC Lifecourse Epidemiology Unit (GB)
- National Research Council (IT)
- ASST Fatebenefratelli Sacco (IT)
- Mertiva (Sweden) (SE)
- Instituto de Investigación Sanitaria del Principado de Asturias (ES)
- University of Southampton (GB)
- Monash University (AU)
- Geneva College (US)
- Columbia University (US)
- University of Amsterdam (NL)
- Aalborg University (DK)
- University of Sheffield (GB)
- KU Leuven (BE)
Publication Details
- Journal
- Nephrology Dialysis Transplantation
- Published
- 2025-11-25
- DOI
- https://doi.org/10.1093/ndt/gfaf256
- Primary Topic
- Parathyroid Disorders and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Amgen
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Gilead Sciences
- Alexion Pharmaceuticals
- Alnylam Pharmaceuticals
- Gedeon Richter
- Novo Nordisk
- Vifor Pharma
- Servier