{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:27:19Z","timestamp":1787243239627,"version":"build-2736575974"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"\n Background:<\/jats:title>\n Reduced bone mineral density and fractures are well-established complications in advanced CKD, but the role of mild to moderate CKD and albuminuria remain unclear. We assessed whether albuminuria modifies the association between CKD stage and bone mineral density and risk of major osteoporotic fractures.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Participants from the HUNT and Troms\u00f8 studies (n=31,341) provided data on CKD (classified by eGFR G1 (\u226590), G2 (60\u201389), G3a (45\u201359), and G3b\/G4 (<45 mL\/min\/1.73 m\n 2<\/jats:sup>\n )), albuminuria (defined by albumin-creatinine ratio: A1 (<30 mg\/g) and A2\/A3 (\u226530 mg\/g)) and fractures. We estimated mean bone mineral density differences and hazard ratios (HRs) using linear mixed models and Cox regression. Effect modification was assessed using an interaction term and Wald test. Linear combinations were used to estimate pairwise contrasts between CKD\u2013albuminuria categories (reference: CKD G1 and albuminuria A1), and within CKD stages.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Compared with G1, bone mineral density was modestly lower and fracture risk was highest in G3b\/G4 (HR 1.40; 95% confidence interval [CI]: 1.12 to 1.74). Albuminuria (A2\/A3) was associated with both lower bone mineral density and slightly higher fracture risk compared with A1, independent of eGFR. Patterns differed by albuminuria category: In A1, bone mineral density remained stable across CKD stages, whereas in A2\/A3 it was progressively lower from G3a onward. Fracture risk increased with CKD severity in both albuminuria categories and was consistently higher in A2\/A3 across advancing CKD stages. In G3b\/G4, HRs were 1.27 (CI: 0.96 to 1.68) in A1 and 1.58 (CI: 1.07 to 2.36) in A2\/A3.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Lower bone mineral density was observed in advanced CKD with albuminuria. Fracture risk increased from CKD stage G3a and tended to be higher in the presence of albuminuria, indicating an association between albuminuria and impaired bone health.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0000001312","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:03:08Z","timestamp":1787241788000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Kidney Function and Albuminuria Associated with Bone Mineral Density and Fracture Risk"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5603-9529","authenticated-orcid":false,"given":"Ingebj\u00f8rg","family":"Tronstad","sequence":"first","affiliation":[{"name":"HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Levanger Norway"},{"name":"Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Tr\u00f8ndelag Hospital Trust, Levanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8546-0791","authenticated-orcid":false,"given":"Solfrid","family":"Romundstad","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Tr\u00f8ndelag Hospital Trust, Levanger Norway"},{"name":"Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4331-7548","authenticated-orcid":false,"given":"Marit D.","family":"Solbu","sequence":"additional","affiliation":[{"name":"Section of Nephrology, University Hospital of North Norway, Troms\u00f8, Norway"},{"name":"Metabolic and Renal Research Group, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1344-9707","authenticated-orcid":false,"given":"Julie","family":"Horn","sequence":"additional","affiliation":[{"name":"HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Levanger Norway"},{"name":"Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Tr\u00f8ndelag Hospital Trust, Levanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7912-5786","authenticated-orcid":false,"given":"Jonas","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid A. Aa","family":"Vikjord","sequence":"additional","affiliation":[{"name":"HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Levanger Norway"},{"name":"Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine and Orkdal Dept. of Internal Medicine, St. Olav\u2019s Hospital, Trondheim University Hospital, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-3544","authenticated-orcid":false,"given":"Tom I.L.","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Clinic of Emergency Medicine and Prehospital Care, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5296-6673","authenticated-orcid":false,"given":"Arnulf","family":"Langhammer","sequence":"additional","affiliation":[{"name":"HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU \u2013 Norwegian University of Science and Technology, Levanger Norway"},{"name":"Levanger Hospital, Nord-Tr\u00f8ndelag Hospital Trust, Levanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,20]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:03:09Z","timestamp":1787241789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001312"}},"subtitle":["The Troms\u00f8 and Tr\u00f8ndelag Health Studies"],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001312","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"assertion":[{"value":"2026-02-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}