Differences between CKD-MBD and postmenopausal osteoporosis

Clinical factor	CKD-MBD	Postmenopausal osteoporosis
PTH levels	Increased	Usually normal*
Alkaline phosphatase	Increased	Usually normal*
Bone mineral density	Weakly related to fracture risk	Predicts risk of fracture
Bone loss	Mostly in cortical bone	Trabecular and cortical bone
Bone formation rate	Either very low (in adynamic bone disease) or very high	Generally normal or slightly increased
Vascular calcification	Strongly associated	Weakly associated
Laboratory findings^¶	Abnormal	Normal or mildly abnormal

CKD-MBD: chronic kidney disease-mineral and bone disorder; PTH: parathyroid hormone; FGF-23: fibroblast growth factor 23; BMP-7: bone morphogenetic protein 7.
* May be increased if secondary or primary hyperparathyroidism exists
¶ Including levels of calcium ions, phosphate, FGF-23, BMP-7, Klotho, 1,25-hydroxyvitamin D3, iron, bicarbonate, sclerostin, and cytokines.

Adapted by permission from Macmillan Publishers Ltd: Nature Reviews Nephrology. Ott SM. Therapy for patients with CKD and low bone mineral density. Nat Rev Nephrol 2013; 9:681. Copyright © 2013. www.nature.com/nrneph/.

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Differences between CKD-MBD and postmenopausal osteoporosis