{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:00:47Z","timestamp":1774929647928,"version":"3.50.1"},"reference-count":173,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:00:00Z","timestamp":1696032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CSL Vifor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chronic kidney disease (CKD) is a significant public health concern associated with significant morbidity and has become one of the foremost global causes of death in recent years. A frequent comorbidity of CKD is secondary hyperparathyroidism (SHPT), exemplified by high serum parathyroid hormone (PTH) levels. The mineral metabolism disturbances resulting from CKD and progression to SHPT are currently considered part of the definition of chronic kidney disease\u2013mineral and bone disorder (CKD-MBD). However, CKD-MBD does not only include abnormalities in laboratory-measured parameters; it is a complex condition characterized by dysregulation of bone turnover, mineralization, growth and strength, accompanied by vascular or another soft-tissue calcification. Together, this increases the risk of bone fractures, cardiovascular disease, and overall mortality in CKD-MBD patients. Monitoring serum markers is essential in diagnosing SHPT and CKD-MBD, and there are several recognized indicators for prognosis, optimal clinical management and treatment response in late-stage kidney disease patients receiving dialysis. However, far fewer markers have been established for patients with non-dialysis CKD. This review provides an overview of current and emerging markers and tools used in the diagnosis and management of CKD-MBD in non-dialysis adult patients.<\/jats:p>","DOI":"10.3390\/jcm12196306","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:28:08Z","timestamp":1696220888000},"page":"6306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Current and Emerging Markers and Tools Used in the Diagnosis and Management of Chronic Kidney Disease\u2013Mineral and Bone Disorder in Non-Dialysis Adult Patients"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9478-4851","authenticated-orcid":false,"given":"Maria","family":"Fusaro","sequence":"first","affiliation":[{"name":"National Research Council (CNR)\u2014Institute of Clinical Physiology (IFC), Via G. Moruzzi 1, 56124 Pisa, Italy"},{"name":"Department of Medicine, University of Padova, Via Giustiniani, 2, 35128 Padova, Italy"}]},{"given":"Luciano","family":"Pereira","sequence":"additional","affiliation":[{"name":"Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal"},{"name":"INEB\u2014National Institute of Biomedical Engineering, University of Porto, 4150-180 Porto, Portugal"},{"name":"DaVita Kidney Care, 4200-448 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-250 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3577-2273","authenticated-orcid":false,"given":"Jordi","family":"Bover","sequence":"additional","affiliation":[{"name":"Nephrology Department, University Hospital Germans Trias i Pujol (HGiTP), 08916 Barcelona, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,30]]},"reference":[{"key":"ref_1","unstructured":"GBD Chronic Kidney Disease Collaboration (2020). Global, Regional, and National Burden of Chronic Kidney Disease, 1990\u20132017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet Lond. Engl., 395, 709\u2013733."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting Life Expectancy, Years of Life Lost, and All-Cause and Cause-Specific Mortality for 250 Causes of Death: Reference and Alternative Scenarios for 2016-40 for 195 Countries and Territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet Lond. Engl."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"913","DOI":"10.2215\/CJN.06040710","article-title":"Secondary Hyperparathyroidism: Pathogenesis, Disease Progression, and Therapeutic Options","volume":"6","author":"Cunningham","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"(2017). Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl., 7, 1\u201359.","DOI":"10.1016\/j.kisu.2017.04.001"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/ckj\/sfy061","article-title":"Novel Insights into Parathyroid Hormone: Report of The Parathyroid Day in Chronic Kidney Disease","volume":"12","author":"Vervloet","year":"2019","journal-title":"Clin. Kidney J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1007\/s40620-021-01082-2","article-title":"Where Are We Now? Emerging Opportunities and Challenges in the Management of Secondary Hyperparathyroidism in Patients with Non-Dialysis Chronic Kidney Disease","volume":"34","author":"Ketteler","year":"2021","journal-title":"J. Nephrol."},{"key":"ref_7","first-page":"514","article-title":"Hyporesponsiveness or Resistance to the Action of Parathyroid Hormone in Chronic Kidney Disease","volume":"41","author":"Bover","year":"2021","journal-title":"Nefrol. Engl. Ed."},{"key":"ref_8","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group (2009). KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl., 76, S1\u2013S130."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"962","DOI":"10.2215\/CJN.11031017","article-title":"Management of Osteoporosis in CKD","volume":"13","author":"Khairallah","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S2213-8587(14)70059-2","article-title":"Bone: A New Endocrine Organ at the Heart of Chronic Kidney Disease and Mineral and Bone Disorders","volume":"2","author":"Vervloet","year":"2014","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S2213-8587(17)30310-8","article-title":"Bone and Mineral Disorders in Chronic Kidney Disease: Implications for Cardiovascular Health and Ageing in the General Population","volume":"6","author":"Covic","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/sj.ki.5002009","article-title":"Prevalence of Abnormal Serum Vitamin D, PTH, Calcium, and Phosphorus in Patients with Chronic Kidney Disease: Results of the Study to Evaluate Early Kidney Disease","volume":"71","author":"Levin","year":"2007","journal-title":"Kidney Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1053\/j.ajkd.2007.12.018","article-title":"Trends in Mineral Metabolism: Kidney Early Evaluation Program (KEEP) and the National Health and Nutrition Examination Survey (NHANES) 1999\u20132004","volume":"51","author":"Vassalotti","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e872193","DOI":"10.1155\/2015\/872193","article-title":"Soluble \u03b1-Klotho Serum Levels in Chronic Kidney Disease","volume":"2015","author":"Rotondi","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dalle Carbonare, L., Valenti, M.T., Giannini, S., Gallieni, M., Stefani, F., Ciresa, R., Politi, C., and Fusaro, M. (2021). Bone Biopsy for Histomorphometry in Chronic Kidney Disease (CKD): State-of-the-Art and New Perspectives. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194617"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Fusaro, M., Re Sart\u00f2, G.V., Gallieni, M., Cosmai, L., Messa, P., Rossini, M., Chiodini, I., Plebani, M., Evenepoel, P., and Harvey, N. (2022). Time for Revival of Bone Biopsy with Histomorphometric Analysis in Chronic Kidney Disease (CKD): Moving from Skepticism to Pragmatism. Nutrients, 14.","DOI":"10.3390\/nu14091742"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1093\/ndt\/gfaa192","article-title":"European Consensus Statement on the Diagnosis and Management of Osteoporosis in Chronic Kidney Disease Stages G4-G5D","volume":"36","author":"Evenepoel","year":"2021","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0021-9150(97)00106-8","article-title":"New Indices to Classify Location, Severity and Progression of Calcific Lesions in the Abdominal Aorta: A 25-Year Follow-up Study","volume":"132","author":"Kauppila","year":"1997","journal-title":"Atherosclerosis"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1093\/ndt\/gfh217","article-title":"A Simple Vascular Calcification Score Predicts Cardiovascular Risk in Haemodialysis Patients","volume":"19","author":"Adragao","year":"2004","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s40620-017-0408-8","article-title":"CKD-MBD working group of ERA-EDTA Circulating Markers of Bone Turnover","volume":"30","author":"Vervloet","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1093\/ndt\/gfz133","article-title":"Valvular Heart Disease and Calcification in CKD: More Common than Appreciated","volume":"35","author":"Raggi","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"642718","DOI":"10.3389\/fmed.2021.642718","article-title":"Clinical Approach to Vascular Calcification in Patients with Non-Dialysis Dependent Chronic Kidney Disease: Mineral-Bone Disorder-Related Aspects","volume":"8","author":"Bover","year":"2021","journal-title":"Front. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s00223-020-00781-5","article-title":"The Non-Invasive Diagnosis of Bone Disorders in CKD","volume":"108","author":"Bover","year":"2021","journal-title":"Calcif. Tissue Int."},{"key":"ref_24","first-page":"4","article-title":"Chronic Kidney Disease\u2014Mineral and Bone Disorder: Pathophysiology and Treatment","volume":"8","author":"Parker","year":"2016","journal-title":"Pharm. J."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Duque, E.J., Elias, R.M., and Moys\u00e9s, R.M.A. (2020). Parathyroid Hormone: A Uremic Toxin. Toxins, 12.","DOI":"10.3390\/toxins12030189"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"c268","DOI":"10.1159\/000276579","article-title":"Low-Dose Alfacalcidol Controls Secondary Hyperparathyroidism in Predialysis Chronic Kidney Disease","volume":"114","author":"Reichel","year":"2010","journal-title":"Nephron Clin. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1681\/ASN.2006070771","article-title":"Metabolic Bone Disease in Chronic Kidney Disease","volume":"18","author":"Martin","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s40620-013-0001-8","article-title":"Interaction between Phosphorus and Parathyroid Hormone in Non-Dialysis CKD Patients under Nephrology Care","volume":"27","author":"Conte","year":"2014","journal-title":"J. Nephrol."},{"key":"ref_29","first-page":"1731","article-title":"New Lessons from Old Assays: Parathyroid Hormone (PTH), Its Receptors, and the Potential Biological Relevance of PTH Fragments","volume":"17","author":"Goodman","year":"2002","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"941","DOI":"10.4314\/ahs.v15i3.31","article-title":"Prevalence of CKD-MBD in Pre-Dialysis Patients Using Biochemical Markers in Enugu, South-East Nigeria","volume":"15","author":"Okoye","year":"2015","journal-title":"Afr. Health Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"381","DOI":"10.3343\/alm.2017.37.5.381","article-title":"Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients","volume":"37","author":"Einbinder","year":"2017","journal-title":"Ann. Lab. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1053\/j.ajkd.2018.06.031","article-title":"The Role of Vitamin D in CKD Stages 3 to 4: Report of a Scientific Workshop Sponsored by the National Kidney Foundation","volume":"72","author":"Melamed","year":"2018","journal-title":"Am. J. Kidney Dis. Off. J. Natl. Kidney Found."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s40620-020-00916-9","article-title":"Disorders in Bone-Mineral Parameters and the Risk of Death in Persons with Chronic Kidney Disease Stages 4 and 5: The PECERA Study","volume":"34","author":"Molina","year":"2021","journal-title":"J. Nephrol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"810","DOI":"10.2215\/CJN.08680811","article-title":"Combined Use of Vitamin D Status and FGF23 for Risk Stratification of Renal Outcome","volume":"7","author":"Nakano","year":"2012","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_35","first-page":"1397","article-title":"ERA CKD-MBD Working Groups Treatment of Secondary Hyperparathyroidism in Non-Dialysis CKD: An Appraisal 2022s","volume":"38","author":"Ketteler","year":"2022","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nefro.2022.03.007","article-title":"Recomendaciones De La Sociedad Espanola De Nefrologia Para El Manejo De Las Alteraciones Del Metabolismo Oseo-Mineral En Los Pacientes Con Enfermedad Renal Cronica. 2021 (SEN-MM)","volume":"42","author":"Torregrosa","year":"2022","journal-title":"Nefrolog\u00eda"},{"key":"ref_37","first-page":"613","article-title":"Independent Effects of Parathyroid Hormone and Phosphate Levels on Hard Outcomes in Non-Dialysis Patients: Food for Thought","volume":"37","author":"Torres","year":"2022","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_38","first-page":"160","article-title":"The Risk of Medically Uncontrolled Secondary Hyperparathyroidism Depends on Parathyroid Hormone Levels at Haemodialysis Initiation","volume":"36","author":"Tabibzadeh","year":"2021","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2147\/IJNRD.S191156","article-title":"Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD): Current Perspectives","volume":"12","author":"Waziri","year":"2019","journal-title":"Int. J. Nephrol. Renov. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1159\/000450766","article-title":"Use of Extended-Release Calcifediol to Treat Secondary Hyperparathyroidism in Stages 3 and 4 Chronic Kidney Disease","volume":"44","author":"Sprague","year":"2016","journal-title":"Am. J. Nephrol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1158\/1055-9965.EPI-10-1257","article-title":"Vitamin D: Marker or Mechanism of Action?","volume":"20","author":"Jacobs","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev. Publ. Am. Assoc. Cancer Res. Cosponsored Am. Soc. Prev. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Bover, J., Mass\u00f3, E., Gifre, L., Alfieri, C., Soler-Majoral, J., Fusaro, M., Calabia, J., Rodr\u00edguez-Pena, R., Rodr\u00edguez-Chitiva, N., and L\u00f3pez-B\u00e1ez, V. (2023). Vitamin D and Chronic Kidney Disease Association with Mineral and Bone Disorder: An Appraisal of Tangled Guidelines. Nutrients, 15.","DOI":"10.3390\/nu15071576"},{"key":"ref_43","first-page":"707","article-title":"Relationship between Serum Phosphorus and the Progression of Advanced Chronic Kidney Disease","volume":"31","author":"Caravaca","year":"2011","journal-title":"Nefrologia"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1080\/0886022X.2018.1455594","article-title":"Fibroblast Growth Factor-23 Is a Strong Predictor of Insulin Resistance among Chronic Kidney Disease Patients","volume":"40","author":"Fayed","year":"2018","journal-title":"Ren. Fail."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3389\/fendo.2018.00189","article-title":"FGF23 Actions on Target Tissues-With and Without Klotho","volume":"9","author":"Richter","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_46","first-page":"50","article-title":"Klotho Gene, Phosphocalcic Metabolism, and Survival in Dialysis","volume":"19","author":"Torres","year":"2009","journal-title":"J. Ren. Nutr. Off. J. Counc. Ren. Nutr. Natl. Kidney Found."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00223-021-00844-1","article-title":"Vitamin D Supplementation for Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analyses of Trials Investigating the Response to Supplementation and an Overview of Guidelines","volume":"109","author":"Christodoulou","year":"2021","journal-title":"Calcif. Tissue Int."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100","DOI":"10.5527\/wjn.v6.i3.100","article-title":"Role of Different Imaging Modalities of Vascular Calcification in Predicting Outcomes in Chronic Kidney Disease","volume":"6","author":"Disthabanchong","year":"2017","journal-title":"World J. Nephrol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.jacc.2018.05.027","article-title":"Coronary Calcium Score and Cardiovascular Risk","volume":"72","author":"Greenland","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3389\/fendo.2018.00267","article-title":"Physiological Actions of Fibroblast Growth Factor-23","volume":"9","author":"Erben","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1001\/jama.2011.826","article-title":"Fibroblast Growth Factor 23 and Risks of Mortality and End-Stage Renal Disease in Patients with Chronic Kidney Disease","volume":"305","author":"Isakova","year":"2011","journal-title":"JAMA"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/nep.12664","article-title":"FGF-23 and Osteoprotegerin but Not Fetuin-A Are Associated with Death and Enhance Risk Prediction in Non-Dialysis Chronic Kidney Disease Stages 3-5","volume":"21","author":"Alderson","year":"2016","journal-title":"Nephrol. Carlton Vic."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1159\/000454959","article-title":"Fibroblast Growth Factor 23 Predicts All-Cause Mortality in a Dose-Response Fashion in Pre-Dialysis Patients with Chronic Kidney Disease","volume":"45","author":"Xue","year":"2017","journal-title":"Am. J. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Kanda, E., Yoshida, M., and Sasaki, S. (2012). Applicability of Fibroblast Growth Factor 23 for Evaluation of Risk of Vertebral Fracture and Chronic Kidney Disease-Mineral Bone Disease in Elderly Chronic Kidney Disease Patients. BMC Nephrol., 13.","DOI":"10.1186\/1471-2369-13-122"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1159\/000510351","article-title":"Fibroblast Growth Factor 23 and \u03b1-Klotho Protein Are Associated with Adverse Clinical Outcomes in Non-Dialysis CKD Patients","volume":"45","author":"Manou","year":"2020","journal-title":"Kidney Blood Press. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3389\/fendo.2017.00323","article-title":"New Insights into the Mechanism of Action of Soluble Klotho","volume":"8","author":"Dalton","year":"2017","journal-title":"Front. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/36285","article-title":"Mutation of the Mouse Klotho Gene Leads to a Syndrome Resembling Ageing","volume":"390","author":"Matsumura","year":"1997","journal-title":"Nature"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1126\/science.1112766","article-title":"Suppression of Aging in Mice by the Hormone Klotho","volume":"309","author":"Kurosu","year":"2005","journal-title":"Science"},{"key":"ref_59","first-page":"2650","article-title":"The Emerging Role of Klotho in Clinical Nephrology","volume":"27","author":"Hu","year":"2012","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1053\/j.ajkd.2013.01.024","article-title":"Circulating \u03b1-Klotho Levels in CKD and Relationship to Progression","volume":"61","author":"Kim","year":"2013","journal-title":"Am. J. Kidney Dis. Off. J. Natl. Kidney Found."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1038\/ki.2012.288","article-title":"Plasma Klotho Is Not Related to Kidney Function and Does Not Predict Adverse Outcome in Patients with Chronic Kidney Disease","volume":"83","author":"Seiler","year":"2013","journal-title":"Kidney Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1007\/s10157-012-0621-7","article-title":"Serum Levels of Soluble Secreted \u03b1-Klotho Are Decreased in the Early Stages of Chronic Kidney Disease, Making It a Probable Novel Biomarker for Early Diagnosis","volume":"16","author":"Shimamura","year":"2012","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1159\/000452880","article-title":"Klotho\/FGF23 Axis in Chronic Kidney Disease and Cardiovascular Disease","volume":"3","author":"Lu","year":"2017","journal-title":"Kidney Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"162","DOI":"10.2215\/CJN.02840320","article-title":"Klotho in Clinical Nephrology: Diagnostic and Therapeutic Implications","volume":"16","author":"Neyra","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1159\/000506380","article-title":"Serum Klotho, Cardiovascular Events, and Mortality in Nondiabetic Chronic Kidney Disease","volume":"10","author":"Yang","year":"2020","journal-title":"Cardiorenal Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"711904","DOI":"10.3389\/fphys.2021.711904","article-title":"Correlation between Soluble Klotho and Vascular Calcification in Chronic Kidney Disease: A Meta-Analysis and Systematic Review","volume":"12","author":"Liu","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"857","DOI":"10.2147\/IJGM.S299197","article-title":"The Clinical Value of Klotho and FGF23 in Cardiac Valve Calcification Among Patients with Chronic Kidney Disease","volume":"14","author":"Chen","year":"2021","journal-title":"Int. J. Gen. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"931746","DOI":"10.3389\/fphar.2022.931746","article-title":"The Controversy of Klotho as a Potential Biomarker in Chronic Kidney Disease","volume":"13","author":"Yu","year":"2022","journal-title":"Front. Pharmacol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4103\/tcmj.tcmj_36_20","article-title":"Vascular Calcification of Chronic Kidney Disease: A Brief Review","volume":"33","author":"Hsu","year":"2021","journal-title":"Tzu Chi Med. J."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e000481","DOI":"10.1161\/JAHA.113.000481","article-title":"Medial and Intimal Calcification in Chronic Kidney Disease: Stressing the Contributions","volume":"2","author":"Rogers","year":"2013","journal-title":"J. Am. Heart Assoc."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/1074248419838501","article-title":"Involvement of Vitamin K-Dependent Proteins in Vascular Calcification","volume":"24","author":"Tesfamariam","year":"2019","journal-title":"J. Cardiovasc. Pharmacol. Ther."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1159\/000096744","article-title":"Calcifications, Arterial Stiffness and Atherosclerosis","volume":"44","author":"Mackey","year":"2007","journal-title":"Adv. Cardiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.atherosclerosis.2020.03.007","article-title":"New Insights into Endogenous Mechanisms of Protection against Arterial Calcification","volume":"306","year":"2020","journal-title":"Atherosclerosis"},{"key":"ref_74","first-page":"1915","article-title":"Klotho and Calciprotein Particles as Therapeutic Targets against Accelerated Ageing","volume":"135","year":"2021","journal-title":"Clin. Sci. Lond. Engl. 1979"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1038\/ki.2008.644","article-title":"The Emerging Role of Phosphate in Vascular Calcification","volume":"75","author":"Giachelli","year":"2009","journal-title":"Kidney Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/hy1001.096358","article-title":"Arterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease","volume":"38","author":"Blacher","year":"2001","journal-title":"Hypertension"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1161\/CIRCULATIONAHA.120.050686","article-title":"Cardiovascular Disease in Chronic Kidney Disease","volume":"143","author":"Jankowski","year":"2021","journal-title":"Circulation"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Marreiros, C., Viegas, C., and Simes, D. (2022). Targeting a Silent Disease: Vascular Calcification in Chronic Kidney Disease. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232416114"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S0272-6386(96)90363-7","article-title":"Electron Beam Computed Tomography in the Evaluation of Cardiac Calcification in Chronic Dialysis Patients","volume":"27","author":"Braun","year":"1996","journal-title":"Am. J. Kidney Dis. Off. J. Natl. Kidney Found."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e300","DOI":"10.1259\/bjr\/91904659","article-title":"Comparison of Dual-Source and Electron-Beam CT for the Assessment of Coronary Artery Calcium Scoring","volume":"85","author":"Reinsch","year":"2012","journal-title":"Br. J. Radiol."},{"key":"ref_81","first-page":"719","article-title":"Mild and Moderate Pre-Dialysis Chronic Kidney Disease Is Associated with Increased Coronary Artery Calcium","volume":"7","author":"Roy","year":"2011","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_82","first-page":"4","article-title":"Body Mass Index, Coronary Artery Calcification, and Kidney Function Decline in Stage 3 to 5 Chronic Kidney Disease Patients","volume":"23","author":"Garland","year":"2013","journal-title":"J. Ren. Nutr. Off. J. Counc. Ren. Nutr. Natl. Kidney Found."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1038\/ki.2010.70","article-title":"Coronary Artery Calcification and Mortality in Diabetic Patients with Proteinuria","volume":"77","author":"Chiu","year":"2010","journal-title":"Kidney Int."},{"key":"ref_84","first-page":"1715","article-title":"Relationship of Coronary Artery Calcification with Renal Function Decline and Mortality in Predialysis Chronic Kidney Disease Patients","volume":"34","author":"Lamarche","year":"2019","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc. Eur. Ren. Assoc."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/ckj\/sfz095","article-title":"Association of Non-Invasive Measures of Subclinical Atherosclerosis and Arterial Stiffness with Mortality and Major Cardiovascular Events in Chronic Kidney Disease: Systematic Review and Meta-Analysis of Cohort Studies","volume":"13","author":"Kouis","year":"2020","journal-title":"Clin. Kidney J."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"gfac073.011","DOI":"10.1093\/ndt\/gfac073.011","article-title":"MO547: A Novel Quantitative Computer-Assisted Score Can Improve Repeatability in the Estimate of Vascular Calcifications at the Abdominal Aorta","volume":"37","author":"Fusaro","year":"2022","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s40620-013-0021-4","article-title":"Abdominal Aortic Calcification and Renal Resistive Index in Patients with Chronic Kidney Disease: Is There a Connection?","volume":"27","author":"Stefan","year":"2014","journal-title":"J. Nephrol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"380","DOI":"10.5414\/CN109441","article-title":"Relationships between Abdominal Aortic Calcification, Glomerular Filtration Rate, and Cardiovascular Risk Factors in Patients with Non-Dialysis Dependent Chronic Kidney Disease","volume":"90","author":"Zhou","year":"2018","journal-title":"Clin. Nephrol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"654","DOI":"10.2215\/CJN.07450714","article-title":"Vascular Calcification in Patients with Nondialysis CKD over 3 Years","volume":"10","author":"Molina","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Neto, R., Pereira, L., Magalh\u00e3es, J., Quelhas-Santos, J., and Fraz\u00e3o, J. (2021). Low Bone Turnover Is Associated with Plain X-Ray Vascular Calcification in Predialysis Patients. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258284"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1093\/ckj\/sfab178","article-title":"Prevalence, Progression and Implications of Breast Artery Calcification in Patients with Chronic Kidney Disease","volume":"15","author":"Pottel","year":"2022","journal-title":"Clin. Kidney J."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.1093\/eurheartj\/ehl254","article-title":"Expert Consensus Document on Arterial Stiffness: Methodological Issues and Clinical Applications","volume":"27","author":"Laurent","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"188","DOI":"10.5414\/CNP75188","article-title":"Effects of Peritoneal Dialysis and Hemodialysis on Arterial Stiffness Compared with Predialysis Patients","volume":"75","author":"Yang","year":"2011","journal-title":"Clin. Nephrol."},{"key":"ref_94","first-page":"S56","article-title":"Prevalence of Arterial Stiffness and Associated Factors in Thai Patients with Chronic Kidney Disease and Kidney Transplant Recipients","volume":"100","author":"Thanakitcharu","year":"2017","journal-title":"J. Med. Assoc. Thail. Chotmaihet Thangphaet"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1038\/s41598-018-19334-w","article-title":"Relationship between Brachial-Ankle and Heart-Femoral Pulse Wave Velocities and the Rapid Decline of Kidney Function","volume":"8","author":"Lee","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1159\/000499648","article-title":"Arterial Stiffness as a Risk Factor for Subclinical Coronary Artery Calcification in Predialysis Chronic Kidney Disease: From the KNOW-CKD Study","volume":"44","author":"Hyun","year":"2019","journal-title":"Kidney Blood Press. Res."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1016\/j.transproceed.2020.01.132","article-title":"Arterial Stiffness Assessed by Oscillometric Method in Kidney Transplant, Predialysis, and Dialysis Patients","volume":"52","author":"Olczyk","year":"2020","journal-title":"Transplant. Proc."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e20200245","DOI":"10.1590\/1677-5449.200245","article-title":"The Association between Hba1c and Arterial Stiffness among Non-Diabetic Patients with Chronic Kidney Disease","volume":"20","author":"Turgutkaya","year":"2021","journal-title":"J. Vasc. Bras."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1111\/j.2042-7158.2012.01561.x","article-title":"Role of Fetuin-A in Atherosclerosis Associated with Diabetic Patients","volume":"64","author":"Singh","year":"2012","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Chekol Abebe, E., Tilahun Muche, Z., Behaile T\/Mariam, A., Mengie Ayele, T., Mekonnen Agidew, M., Teshome Azezew, M., Abebe Zewde, E., Asmamaw Dejenie, T., and Asmamaw Mengstie, M. (2022). The Structure, Biosynthesis, and Biological Roles of Fetuin-A: A Review. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.945287"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1161\/ATVBAHA.120.315697","article-title":"Calciprotein Particles: Balancing Mineral Homeostasis and Vascular Pathology","volume":"41","author":"Kutikhin","year":"2021","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s00424-022-02688-6","article-title":"Tissue Chaperoning-the Expanded Functions of Fetuin-A beyond Inhibition of Systemic Calcification","volume":"474","author":"Rudloff","year":"2022","journal-title":"Pflugers Arch."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2054","DOI":"10.1093\/eurheartj\/ehp158","article-title":"Association of Fetuin-A Levels with the Progression of Aortic Valve Calcification in Non-Dialyzed Patients","volume":"30","author":"Koos","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1080\/0886022X.2021.1969248","article-title":"The Relationship between Calcification Inhibitor Levels in Chronic Kidney Disease and the Development of Atherosclerosis","volume":"43","author":"Sevinc","year":"2021","journal-title":"Ren. Fail."},{"key":"ref_105","first-page":"1957","article-title":"Phosphorylated Fetuin-A-Containing Calciprotein Particles Are Associated with Aortic Stiffness and a Procalcific Milieu in Patients with Pre-Dialysis CKD","volume":"27","author":"Smith","year":"2012","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"966","DOI":"10.3389\/fphys.2019.00966","article-title":"Circulating Fetuin-A and Risk of All-Cause Mortality in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis","volume":"10","author":"Zhou","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"F618","DOI":"10.1152\/ajprenal.00278.2020","article-title":"Vitamin K Deficiency: An Emerging Player in the Pathogenesis of Vascular Calcification and an Iatrogenic Consequence of Therapies in Advanced Renal Disease","volume":"319","author":"Levy","year":"2020","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"6586","DOI":"10.1038\/s41598-020-63013-8","article-title":"Matrix Gla Protein Is an Independent Predictor of Both Intimal and Medial Vascular Calcification in Chronic Kidney Disease","volume":"10","author":"Jaminon","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.bone.2011.01.016","article-title":"Association of Bone Turnover Markers and Arterial Stiffness in Pre-Dialysis Chronic Kidney Disease (CKD)","volume":"48","author":"Manghat","year":"2011","journal-title":"Bone"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"568","DOI":"10.2215\/CJN.07081009","article-title":"The Circulating Inactive Form of Matrix Gla Protein Is a Surrogate Marker for Vascular Calcification in Chronic Kidney Disease: A Preliminary Report","volume":"5","author":"Schurgers","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1159\/000443426","article-title":"Plasma Desphospho-Uncarboxylated Matrix Gla Protein as a Marker of Kidney Damage and Cardiovascular Risk in Advanced Stage of Chronic Kidney Disease","volume":"41","author":"Kurnatowska","year":"2016","journal-title":"Kidney Blood Press. Res."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"S931","DOI":"10.1016\/j.dsx.2017.07.019","article-title":"Profile of Chronic Kidney Disease Related-Mineral Bone Disorders in Newly Diagnosed Advanced Predialysis Diabetic Kidney Disease Patients: A Hospital Based Cross-Sectional Study","volume":"11","author":"Ray","year":"2017","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"248","DOI":"10.2174\/15701611113119990146","article-title":"Prevalence of Vertebral Fractures, Vascular Calcifications, and Mortality in Warfarin Treated Hemodialysis Patients","volume":"13","author":"Fusaro","year":"2015","journal-title":"Curr. Vasc. Pharmacol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11914-022-00716-z","article-title":"The Role of Vitamin K in CKD-MBD","volume":"20","author":"Fusaro","year":"2022","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Silaghi, C.N., Ily\u00e9s, T., Van Ballegooijen, A.J., and Cr\u0103ciun, A.M. (2020). Calciprotein Particles and Serum Calcification Propensity: Hallmarks of Vascular Calcifications in Patients with Chronic Kidney Disease. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051287"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"13030","DOI":"10.1038\/s41598-022-17405-7","article-title":"Association between Amorphous Calcium-Phosphate Ratios in Circulating Calciprotein Particles and Prognostic Biomarkers in Hemodialysis Patients","volume":"12","author":"Nakamura","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1681\/ASN.2012030240","article-title":"Nanoparticle-Based Test Measures Overall Propensity for Calcification in Serum","volume":"23","author":"Pasch","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"315","DOI":"10.2215\/CJN.04720416","article-title":"Blood Calcification Propensity, Cardiovascular Events, and Survival in Patients Receiving Hemodialysis in the EVOLVE Trial","volume":"12","author":"Pasch","year":"2017","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1681\/ASN.2013060635","article-title":"Serum Calcification Propensity Predicts All-Cause Mortality in Predialysis CKD","volume":"25","author":"Smith","year":"2014","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.2215\/CJN.04710419","article-title":"Serum Calcification Propensity and Clinical Events in CKD","volume":"14","author":"Bundy","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s11914-015-0267-y","article-title":"An Overview of the Metabolic Functions of Osteocalcin","volume":"13","author":"Wei","year":"2015","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Tacey, A., Qaradakhi, T., Brennan-Speranza, T., Hayes, A., Zulli, A., and Levinger, I. (2018). Potential Role for Osteocalcin in the Development of Atherosclerosis and Blood Vessel Disease. Nutrients, 10.","DOI":"10.3390\/nu10101426"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"101205","DOI":"10.1016\/j.molmet.2021.101205","article-title":"Osteocalcin and Vascular Function: Is There a Cross-Talk?","volume":"49","author":"Tacey","year":"2021","journal-title":"Mol. Metab."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1055\/a-0752-4615","article-title":"Association between Plasma Concentration of Klotho Protein, Osteocalcin, Leptin, Adiponectin, and Bone Mineral Density in Patients with Chronic Kidney Disease","volume":"50","author":"Wisniewska","year":"2018","journal-title":"Horm. Metab. Res. Horm. Stoffwechselforschung Horm. Metab."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/jch.14523","article-title":"Osteocalcin Association with Vascular Function in Chronic Kidney Disease","volume":"24","author":"Guo","year":"2022","journal-title":"J. Clin. Hypertens."},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Zhang, M., Ni, Z., Zhou, W., and Qian, J. (2015). Undercarboxylated Osteocalcin as a Biomarker of Subclinical Atherosclerosis in Non-Dialysis Patients with Chronic Kidney Disease. J. Biomed. Sci., 22.","DOI":"10.1186\/s12929-015-0183-6"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2337\/diaspect.21.1.19","article-title":"Secondary Hyperparathyroidism and Chronic Kidney Disease","volume":"21","author":"Tomasello","year":"2008","journal-title":"Diabetes Spectr."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00198-019-05190-5","article-title":"The Association between Chronic Kidney Disease, Falls, and Fractures: A Systematic Review and Meta-Analysis","volume":"31","author":"Goto","year":"2020","journal-title":"Osteoporos. Int."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.kint.2015.12.004","article-title":"Changing Bone Patterns with Progression of Chronic Kidney Disease","volume":"89","author":"Massy","year":"2016","journal-title":"Kidney Int."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1159\/000443451","article-title":"Serum Alkaline Phosphatase Levels Are Not Associated with Increased Death Risk in Prevalent Hemodialysis Patients: 5-Year Experience in a Single Hemodialysis Center","volume":"41","author":"Zhu","year":"2016","journal-title":"Kidney Blood Press. Res."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s40620-016-0292-7","article-title":"Total and Bone-Specific Alkaline Phosphatase Are Associated with Bone Mineral Density over Time in End-Stage Renal Disease Patients Starting Dialysis","volume":"30","author":"Bergman","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1681\/ASN.V73506","article-title":"Plasma Total versus Bone Alkaline Phosphatase as Markers of Bone Turnover in Hemodialysis Patients","volume":"7","author":"Hruby","year":"1996","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1681\/ASN.2008010014","article-title":"Serum Alkaline Phosphatase Predicts Mortality among Maintenance Hemodialysis Patients","volume":"19","author":"Regidor","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.2215\/CJN.10091110","article-title":"Bone Alkaline Phosphatase and Mortality in Dialysis Patients","volume":"6","author":"Drechsler","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_135","first-page":"345","article-title":"Diagnostic Usefulness of Bone Mineral Density and Biochemical Markers of Bone Turnover in Predicting Fracture in CKD Stage 5D Patients--a Single-Center Cohort Study","volume":"27","author":"Iimori","year":"2012","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_136","first-page":"3382","article-title":"Clinical Significance of Bone Alkaline Phosphatase Isoforms, Including the Novel B1x Isoform, in Mild to Moderate Chronic Kidney Disease","volume":"24","author":"Haarhaus","year":"2009","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_137","first-page":"861","article-title":"Bone Mineral Density and Biochemical Markers of Bone Metabolism in Predialysis Patients with Chronic Kidney Disease","volume":"64","author":"Fidan","year":"2016","journal-title":"J. Investig. Med. Off. Publ. Am. Fed. Clin. Res."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.bone.2008.11.016","article-title":"Serum 25-Hydroxyvitamin D as an Independent Determinant of 1-84 PTH and Bone Mineral Density in Non-Diabetic Predialysis CKD Patients","volume":"44","author":"Tomida","year":"2009","journal-title":"Bone"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.cca.2017.04.010","article-title":"Assessment of Bone Turnover Markers to Predict Mineral and Bone Disorder in Men with Pre-Dialysis Non-Diabetic Chronic Kidney Disease","volume":"469","author":"Davina","year":"2017","journal-title":"Clin. Chim. Acta Int. J. Clin. Chem."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/nep.13014","article-title":"The Use of Bone Turnover Markers in Chronic Kidney Disease-Mineral and Bone Disorders","volume":"22","author":"Chiang","year":"2017","journal-title":"Nephrol. Carlton Vic."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/S0272-6386(03)00203-8","article-title":"Correlation between Histomorphometric Parameters of Bone Resorption and Serum Type 5b Tartrate-Resistant Acid Phosphatase in Uremic Patients on Maintenance Hemodialysis","volume":"41","author":"Chu","year":"2003","journal-title":"Am. J. Kidney Dis. Off. J. Natl. Kidney Found."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.2215\/CJN.09470913","article-title":"Bone Mineral Density and Serum Biochemical Predictors of Bone Loss in Patients with CKD on Dialysis","volume":"9","author":"Malluche","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1681\/ASN.2017050584","article-title":"Diagnostic Accuracy of Biomarkers and Imaging for Bone Turnover in Renal Osteodystrophy","volume":"29","author":"Salam","year":"2018","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1365-2265.2008.03187.x","article-title":"Utility of Serum Tartrate-Resistant Acid Phosphatase (TRACP5b) as a Bone Resorption Marker in Patients with Chronic Kidney Disease: Independence from Renal Dysfunction","volume":"69","author":"Yamada","year":"2008","journal-title":"Clin. Endocrinol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1681\/ASN.2010121275","article-title":"Discriminants of Prevalent Fractures in Chronic Kidney Disease","volume":"22","author":"Nickolas","year":"2011","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1373\/clinchem.2007.094953","article-title":"Evaluation of a Fully Automated Serum Assay for Total N-Terminal Propeptide of Type I Collagen in Postmenopausal Osteoporosis","volume":"54","author":"Garnero","year":"2008","journal-title":"Clin. Chem."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s11255-019-02290-3","article-title":"Sclerostin: A New Biomarker of CKD-MBD","volume":"52","author":"Figurek","year":"2020","journal-title":"Int. Urol. Nephrol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1007\/s11255-016-1379-8","article-title":"Sclerostin as a New Key Factor in Vascular Calcification in Chronic Kidney Disease Stages 3 and 4","volume":"48","author":"Lv","year":"2016","journal-title":"Int. Urol. Nephrol."},{"key":"ref_149","first-page":"408","article-title":"Sclerostin in Chronic Kidney Disease-Mineral Bone Disorder Think First before You Block It!","volume":"34","author":"Brandenburg","year":"2019","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1093\/ckj\/sfab081","article-title":"Sclerostin and DKK1 Circulating Levels Associate with Low Bone Turnover in Patients with Chronic Kidney Disease Stages 3 and 4","volume":"14","author":"Neto","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s40620-017-0397-7","article-title":"Adynamic Bone Disease Is a Predominant Bone Pattern in Early Stages of Chronic Kidney Disease","volume":"30","author":"Massy","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/bonekey.2013.95","article-title":"Clinical Utility of Serum Sclerostin Measurements","volume":"2","author":"Clarke","year":"2013","journal-title":"BoneKey Rep."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1038\/ki.2015.258","article-title":"Sclerostin Levels in CKD Patients: An Important, but Not Definitive, Step on the Way to Clinical Use","volume":"88","author":"Delanaye","year":"2015","journal-title":"Kidney Int."},{"key":"ref_154","first-page":"1345","article-title":"Osteoprotegerin and Sclerostin in Chronic Kidney Disease Prior to Dialysis: Potential Partners in Vascular Calcifications","volume":"30","author":"Morena","year":"2015","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc.\u2014Eur. Ren. Assoc."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1007\/s11255-020-02495-x","article-title":"The Relationship between Sclerostin and Carotid Artery Atherosclerosis in Patients with Stage 3-5 Chronic Kidney Disease","volume":"52","author":"Zhao","year":"2020","journal-title":"Int. Urol. Nephrol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"E1854","DOI":"10.1210\/jc.2014-2042","article-title":"Serum Sclerostin and Adverse Outcomes in Nondialyzed Chronic Kidney Disease Patients","volume":"99","author":"Kanbay","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s12288-016-0754-z","article-title":"Bone Histo-Morphology in Chronic Kidney Disease Mineral Bone Disorder","volume":"33","author":"Bembem","year":"2017","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1681\/ASN.V491631","article-title":"The Role of Bone Biopsy in the Management of Patients with Renal Osteodystrophy","volume":"4","author":"Malluche","year":"1994","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/nrneph.2013.198","article-title":"Evaluating Bone Quality in Patients with Chronic Kidney Disease","volume":"9","author":"Malluche","year":"2013","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"S170","DOI":"10.2215\/CJN.01100307","article-title":"Role of Bone Biopsy in Stages 3 to 4 Chronic Kidney Disease","volume":"3","author":"Sprague","year":"2008","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1681\/ASN.2009121208","article-title":"Bone Mass and Microarchitecture in CKD Patients with Fracture","volume":"21","author":"Nickolas","year":"2010","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1007\/s00198-012-1908-y","article-title":"Bone Mineral Density by DXA and HR PQCT Can Discriminate Fracture Status in Men and Women with Stages 3 to 5 Chronic Kidney Disease","volume":"23","author":"Jamal","year":"2012","journal-title":"Osteoporos. Int. J. Establ. Result Coop. Eur. Found. Osteoporos. Natl. Osteoporos. Found. USA"},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s00198-014-2813-3","article-title":"Low Bone Mineral Density and Fractures in Stages 3\u20135 CKD: An Updated Systematic Review and Meta-Analysis","volume":"26","author":"Bucur","year":"2015","journal-title":"Osteoporos. Int. J. Establ. Result Coop. Eur. Found. Osteoporos. Natl. Osteoporos. Found. USA"},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MNH.0000000000000411","article-title":"Fracture Risk and Treatment in Chronic Kidney Disease","volume":"27","author":"Connelly","year":"2018","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_165","first-page":"774","article-title":"How and When to Assess Bone Mineral Density and Bone Quality in Chronic Kidney Disease Patients?","volume":"36","author":"Khairallah","year":"2021","journal-title":"Nephrol. Dial. Transplant. Off. Publ. Eur. Dial. Transpl. Assoc. Eur. Ren. Assoc."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1007\/s00198-020-05670-z","article-title":"Is Dual-Energy Absorptiometry Accurate in the Assessment of Bone Status of Patients with Chronic Kidney Disease?","volume":"32","author":"Kim","year":"2021","journal-title":"Osteoporos. Int. J. Establ. Result Coop. Eur. Found. Osteoporos. Natl. Osteoporos. Found. USA"},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"101166","DOI":"10.1016\/j.bonr.2022.101166","article-title":"Cortical Bone Density by Quantitative Computed Tomography Mirrors Disorders of Bone Structure in Bone Biopsy of Non-Dialysis CKD Patients","volume":"16","author":"Bittencourt","year":"2022","journal-title":"Bone Rep."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5414\/CN109006","article-title":"HR-PQCT Detects Alterations in Bone Microstructure in Men with CKD Stages 3 and 4, Which Are Influenced by Hormonal Changes and Body Composition","volume":"89","author":"Lima","year":"2018","journal-title":"Clin. Nephrol."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1080\/0886022X.2022.2043375","article-title":"Comparison of Bone Microstructures via High-Resolution Peripheral Quantitative Computed Tomography in Patients with Different Stages of Chronic Kidney Disease before and after Starting Hemodialysis","volume":"44","author":"Tsuji","year":"2022","journal-title":"Ren. Fail."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1007\/s00198-020-05458-1","article-title":"Trabecular Bone Score in Patients with Chronic Kidney Disease","volume":"31","author":"Rampersad","year":"2020","journal-title":"Osteoporos. Int."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.ekir.2022.10.023","article-title":"Bone Mineral Density and Vascular Calcification in Children and Young Adults with CKD 4 to 5 or on Dialysis","volume":"8","author":"Lalayiannis","year":"2023","journal-title":"Kidney Int. Rep."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3389\/fendo.2020.00015","article-title":"Added Value of Impact Microindentation in the Evaluation of Bone Fragility: A Systematic Review of the Literature","volume":"11","author":"Schoeb","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.1007\/s00198-017-4065-5","article-title":"Bone Density, Microarchitecture, and Material Strength in Chronic Kidney Disease Patients at the Time of Kidney Transplantation","volume":"28","author":"Herrera","year":"2017","journal-title":"Osteoporos. 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