Evidence map›Paper›PMID 40668510›Full record

ArticleArchives of osteoporosis2025

Real-world data from a national survey on management of CKD-associated osteoporosis among Italian nephrologists.

Maria Fusaro, Althea Cossettini, Giulia Vanessa Re Sartò, Andrea Aghi, Maria Cristina Mereu, Maurizio Gallieni, Laura Cosmai, Antonio Bellasi, Carlo Maria Alfieri, Daniel Cejka and 25 more

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Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Maria FusaroInstitute of Clinical Physiology (IFC), National Research Council (CNR), Pisa, Italy. dante.lucia11@gmail.com.
Althea CossettiniSchool of Specialization in Nephrology, University of Milan, Milan, Italy.
Giulia Vanessa Re SartòUOC Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Fatebenefratelli Hospital, Milan, Italy.
Andrea AghiIndependent Researcher, Padua, Italy.
Maria Cristina MereuIndependent Researcher, Cagliari, Italy.
Maurizio GallieniSchool of Specialization in Nephrology, University of Milan, Milan, Italy.
Laura CosmaiUOC Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Fatebenefratelli Hospital, Milan, Italy.
Antonio BellasiService of Nephrology, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Ospedale Civico, Lugano, Switzerland.
Carlo Maria AlfieriDepartment of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Milan, Italy.
Daniel CejkaDepartment of Medicine III - Nephrology, Hypertension, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz - Elisabethinen Hospital, Linz, Austria.
Eugene McCloskeyDivision of Clinical Medicine, School of Medicine & Population Health, Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK.
Etienne CavalierDepartment of Clinical Chemistry, University of Liège, CIRM, CHU de Liège, 4000, Liège, Belgium.
Nicholas C HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
Thomas L NickolasDivision of Bone and Mineral Diseases, Washington University School of Medicine, St. Louis, MO, USA.
Maria Luisa BrandiItalian Bone Disease Research Foundation, Fondazione Italiana Ricerca Sulle Malattie Dell'Osso (FIRMO), Florence, Italy.
Serge FerrariDivision of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, University of Geneva, CH-1211, Geneva, Switzerland.
Carmela MarinoInstitute of Clinical Physiology (IFC), National Research Council (CNR), Reggio Calabria, Italy.
Sandro GianniniDepartment of Medicine, Medical Clinic 1, University of Padua, Padua, Italy.
Stefania SellaDepartment of Medicine, Medical Clinic 1, University of Padua, Padua, Italy.
Gaetano Paride ArcidiaconoDepartment of Medicine, Medical Clinic 1, University of Padua, Padua, Italy.
Paolo SimioniDepartment of Medicine, Medical Clinic 1, University of Padua, Padua, Italy.
Mario PlebaniUniversity of Padua and QI.LAB.MED, Spin-off of the University of Padua, Padua, Italy.
Martina ZaninottoUniversity of Padua and QI.LAB.MED, Spin-off of the University of Padua, Padua, Italy.
Luca De NicolaDepartment of Advanced Medical and Surgical Sciences, Nephrology Unit, Università Della Campania Luigi Vanvitelli, Naples, Italy.
Carmelita MarcantoniNephrology Unit, University Hospital Gaspare Rodolico San Marco, Catania, Italy.
Martin H de BorstDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Maura RaveraDialisi E Trapianto, Clinica Nefrologica, Policlinico San Martino, Genoa, Italy.
Bruno FredianiDepartment of Medicine, Surgery and Neurosciences, Rheumatology Unit, Siena University Hospital, Siena, Italy.
Jordi BoverNephrology Department, University Hospital Germans Trias i Pujol (HGTiP) & REMAR-IGTP Group, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, 08916, Badalona, Spain.
Marie-Helene Lafage-ProustINSERM U1059, France and Service de Rhumatologie, SAINBIOSE Université Jean Monnet, CHU Saint-Etienne, Saint-Etienne, France.
Jean-Yves ReginsterProtein Research Chair, Biochemistry Dept, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Francesco BertoldoBone Metabolism and Osteoncology Unit, University of Verona, Verona, Italy.
Giovanni TripepiInstitute of Clinical Physiology (IFC), National Research Council (CNR), Reggio Calabria, Italy.
Mathias HaarhausDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
An initiative and on behalf of the CKD-MBD working group the European Renal Association and the Committee of Scientific Advisors and National Societies of the IOF

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic kidney disease (CKD)-associated osteoporosis increases fracture risk, yet clinical guidance remains unclear. A survey of 89 Italian nephrologists revealed heterogeneous biomarker availability and varied treatment approaches. Denosumab was the preferred antiresorptive agent, while anabolic drugs were rarely used. Findings highlight progress in CKD-related bone health management despite existing uncertainties. CKD-associated osteoporosis comprises the skeletal effects of a complex mineral and bone disorder causing increased risks of fragility fractures (FF), cardiovascular events, and mortality. Existing clinical guidance about CKD-associated osteoporosis is vague, leading us to hypothesize that a treatment gap exists and that clinical practice is dependent on local availability of diagnostic tools. PURPOSE AND

methodsThe aim of the current survey was to determine current attitudes and practices among Italian nephrologists regarding the evaluation and management of CKD-associated osteoporosis. An online survey was designed, consisting of 9 thematic groups with a set of 16 closed questions regarding the availability of biomarkers and BTMs at reference laboratories and their use for the diagnosis and treatment of CKD-associated osteoporosis in patients with different stages of CKD, including CKD stages G4-5 and dialysis patients. Results were compared to a previous survey on the use of BTMs from 2022.

resultsEighty-nine Italian nephrologists participated in the survey, reporting that parathyroid hormone (PTH), alkaline phosphatase, and 25-hydroxy-vitamin D measurements were available in 92-100% of their reference laboratories. Measurements for fibroblast growth factor-23, Klotho, Matrix Gla protein, procollagen type 1 N-terminal propeptide, and tartrate-resistant acid phosphatase 5b were available in 64-74% of cases. Regarding PTH cut-off values, 47.2% followed KDOQI and 43.8% followed KDIGO recommendations. Vitamin D was widely used across CKD stages (cholecalciferol 27-37.1%, calcifediol 9-12.4%, calcitriol 47.2-53.9%, and paricalcitol 21.3-30.3). Denosumab was the preferred antiresorptive agent in all CKD stages (22.5%-28.1%), while the use of bisphosphonates was uncommon in advanced CKD. Anabolic drugs were rarely prescribed.

conclusionsThe availability of bone biomarkers is heterogeneous, and an uncertainty still exists regarding the clinical use of biomarkers in CKD-associated osteoporosis. Nonetheless, our findings indicate that Italian nephrologists are increasingly taking proactive steps to prevent and treat bone fragility in CKD patients.

Indexed as

NephrologistsOsteoporosisPractice Patterns, Physicians'Renal Insufficiency, ChronicBiomarkersBone Density Conservation AgentsDenosumabFemaleHumansItalyMaleNephrologySurveys and QuestionnairesVitamin DBiomarkersBone Density Conservation AgentsDenosumabVitamin DBone fractureBone turnover markersCKD-MBDVascular calcification

Identifiers

PMID40668510

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.