{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:44:55Z","timestamp":1788281095529,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chronic kidney disease-mineral and bone disorder (CKD\u2013MDB) is a systemic disorder that occurs as a complication of advanced chronic kidney disease. It includes biochemical alterations (calcium, phosphorus, parathyroid hormone, vitamin D), abnormalities in bone turnover and mineralization, and vascular and soft-tissue calcifications. The development of secondary hyperparathyroidism and profound alterations in bone remodeling culminate in renal osteodystrophy, which contributes to adverse cardiovascular outcomes and increased mortality. This narrative review article aims to summarize the role of novel diagnostic techniques in the early identification of reduced bone mass and risk of fractures in patients with chronic kidney disease. The use of bone turnover markers independent of renal clearance (such as bone-specific alkaline phosphatase, procollagen type 1 N-terminal propeptide and tartrate-resistant acid phosphatase 5b) integrated with dual energy X-ray absorptiometry, trabecular bone score and radiofrequency echographic multispectrometry improves the characterization of mineral status, enabling targeted intervention to prevent bone and cardiovascular complications associated with CKD\u2013MBD.<\/jats:p>","DOI":"10.3390\/jcm15124712","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:11:22Z","timestamp":1781709082000},"page":"4712","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combination of Biomarkers and Novel Diagnostic Tools in the Management of Osteoporosis in Chronic Kidney Disease: An Update"],"prefix":"10.3390","volume":"15","author":[{"given":"Maria Vittoria","family":"Mollica","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cianciolo","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Santoro","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende-Hospital \u201cSS. Annunziata\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3623-826X","authenticated-orcid":false,"given":"Filippo","family":"Fimognari","sequence":"additional","affiliation":[{"name":"Multidisciplinary Medical Department, Azienda Ospedaliera \u201cAnnunziata-Mariano Santo-S. Barbara\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"},{"name":"Nephrology and Dialysis Unit, Ospedale Santa Maria delle Croci, AUSL Romagna, 48121 Ravenna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9805-5244","authenticated-orcid":false,"given":"Miriam","family":"Di Nunzio","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-9869","authenticated-orcid":false,"given":"Rosita","family":"Greco","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Renal Transplant Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende-Hospital \u201cSS. Annunziata\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0220-1653","authenticated-orcid":false,"given":"Lilio","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"},{"name":"Nephrology and Dialysis Unit, Ospedale Santa Maria delle Croci, AUSL Romagna, 48121 Ravenna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Di Dalmazi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"},{"name":"Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3657-2070","authenticated-orcid":false,"given":"Guido","family":"Zavatta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science (DIMEC), Alma Mater Studiorum\u2014University of Bologna, 40138 Bologna, Italy"},{"name":"Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2168-702X","authenticated-orcid":false,"given":"Michele","family":"Provenzano","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Renal Transplant Unit, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende-Hospital \u201cSS. Annunziata\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","unstructured":"GBD 2023 Chronic Kidney Disease Collaborators (2025). Global, regional, and national burden of chronic kidney disease in adults, 1990\u20132023, and its attributable risk factors: A systematic analysis for the Global Burden of Disease Study 2023. 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