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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Osteoporosis in chronic kidney disease (CKD) presents a clinical challenge, as traditional therapies like bisphosphonates are often contraindicated in advanced stages. Denosumab, a non-renally cleared RANKL inhibitor, is a promising alternative but carries a significant risk of hypocalcemia. This study aimed to evaluate the real-world efficacy and safety of Denosumab in patients with advanced CKD and osteoporosis.
This prospective, observational study investigated the effects of denosumab in 30 adult patients diagnosed with CKD Stage 3a or higher and osteoporosis - defined as Bone mineral density (BMD) T-score ≤ -2.5. Participants received 60 mg of denosumab subcutaneously at baseline and at 6 months, along with mandatory calcium and vitamin D supplementation. The primary outcome measured was the change in BMD T-score at 12 months. Secondary outcomes included the incidence of hypocalcemia (serum Calcium < 8.0 mg/dl) and alterations in CKD-MBD markers.
The cohort (n=30) had a mean age of 58.1 years, with 73.3% on maintenance hemodialysis.
Denosumab therapy resulted in a statistically significant improvement in the primary outcome. The mean BMD T-score increased from -2.89 ± 0.27 at baseline to -2.23 ± 0.51 at 12 months, representing a mean increase of 0.66 ± 0.45 (p < 0.001).
There was no significant differences in the subgroup analysis.
Hypocalcemia occurred in 11 patients (36.7%). Of these, 5 patients (16.7%) experienced symptomatic hypocalcemia, which led to the discontinuation of therapy in two cases. The mean calcium nadir occurred between 21 and 28 days after administration.
No cases of osteonecrosis of the jaw was observed. One patient was hospitalized for a fractured neck of femur due to slip and fall in the bathroom.
The treatment also led to significant reductions in markers of bone turnover. From baseline to 52 weeks, mean serum intact Parathyroid hormone decreased significantly from 253.03 ± 74.63 pg/ml to 213.03 ± 74.63 pg/ml (p < 0.05), and mean Alkaline Phosphatase decreased from 247.9 ± 59.53 IU/L to 189.73 ± 74.63 IU/L (p < 0.01).
Patient-reported quality of life was assessed using the KDQOL-36 Physical Component Summary (PCS) T-score, which showed a small, non-statistically significant improvement in the mean score from baseline to 52 weeks
Denosumab is an effective therapy for significantly improving bone mineral density in patients with advanced CKD and osteoporosis. Its use is associated with a risk of hypocalcemia, which necessitates rigorous biochemical monitoring. With careful patient selection, a structured monitoring protocol and proactive management with calcium and vitamin D supplementation, denosumab can be used effectively in this subset of patients without serious adverse effects.
The primary limitation of this study is small sample size and hence, there is a critical need for larger, multicenter, randomized controlled trials to definitively establish the long-term safety profile and fracture-reduction efficacy of Denosumab in advanced CKD population.
