Abstract Background Patients with chronic kidney disease have a high risk of fracture, but evidence-based treatment protocols for osteoporosis are lacking. Bisphosphonates are commonly used anti-resorptive drugs, but due to renal excretion, patients with chronic kidney disease have not been included in clinical trials. Case presentation We present a case of severe bone fragility in a patient on long-term hemodialysis therapy where zoledronate was well-tolerated and provided clinical improvement. Conclusion This case highlights the potential role of bisphosphonates in chronic kidney disease–associated osteoporosis and the need for trials to establish the safety and efficacy of anti-resorptive drugs in this patient population.
Sakthivel et al. (2026) studied this question.