Bone Health Across the Spectrum of Chronic Kidney Disease and Renal Transplantation

Patients with chronic kidney disease (CKD) have exceptionally high fracture rates compared to the general population, with a significantly increased morbidity and mortality. However, the investigation and management of bone health in patients with CKD is currently suboptimal. This PhD examined novel risk factors for fracture in patients with CKD with a focus on the role of hypogonadism and fracture risk, and non-invasive imaging techniques to predict fractures in these patients. Gonadal dysfunction was common, but there was insufficient evidence to define and guide management options relating to gonadal function and bone outcomes. Novel, yet inexpensive and non-invasive imaging techniques were associated with prevalent fractures, and if validated in future prospective studies, their use will enhance current diagnostic algorithms for managing bone health in these patients.