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Kidney Function and Albuminuria Associated with Bone Mineral Density and Fracture Risk: The Tromsø and Trøndelag

Ingebjørg Tronstad1,2, Solfrid Romundstad2,3, Marit D Solbu4,5

  • 1HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Levanger Norway.

Kidney360
|August 20, 2026
PubMed

Insights

Albuminuria exacerbates bone density loss and fracture risk in chronic kidney disease (CKD). Even mild CKD with albuminuria is linked to poorer bone health, highlighting the importance of monitoring both conditions.

Area of Science:

  • Nephrology
  • Endocrinology
  • Geriatrics

Background:

  • Chronic kidney disease (CKD) is linked to reduced bone mineral density and fractures, particularly in advanced stages.
  • The impact of mild to moderate CKD and albuminuria on bone health remains less understood.
  • Investigating the interplay between CKD stage, albuminuria, and skeletal complications is crucial.

Purpose of the Study:

  • To determine if albuminuria modifies the relationship between CKD stage and bone mineral density.
  • To assess the association between CKD stage, albuminuria, and the risk of major osteoporotic fractures.
  • To clarify the role of albuminuria in bone health across different CKD severities.

Main Methods:

  • Utilized data from the HUNT and Tromsø studies (n=31,341) with CKD classification by eGFR and albuminuria levels.
  • Employed linear mixed models and Cox regression to analyze bone mineral density and fracture risk.
  • Investigated effect modification using interaction terms and estimated contrasts between CKD-albuminuria categories.

Main Results:

  • Bone mineral density was lower and fracture risk higher in advanced CKD (G3b/G4).
  • Albuminuria (A2/A3) independently correlated with lower bone mineral density and increased fracture risk.
  • In the presence of albuminuria, bone mineral density decreased progressively from CKD stage G3a, and fracture risk was consistently higher across advancing CKD stages.

Conclusions:

  • Advanced CKD, especially with albuminuria, is associated with reduced bone mineral density.
  • Fracture risk increases from CKD stage G3a and is generally higher with albuminuria.
  • Albuminuria appears to be a significant factor in impaired bone health among CKD patients.
Abstract

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