- AP AKI CRRT2026

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Scientific Research Abstract

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Author & Affiliation

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Co-Author 1 *

Jing-Huan Liao joepoe168@gmail.com Tri-Service General Hospital Department of Internal Medicine Taipei Taiwan *

Co-Author 2 *

Chun-Liang Hsu windoverture@gmail.com Tri-Service General Hospital Department of Orthopaedics Taipei Taiwan -

Co-Author 3 *

Yu-Juei Hsu yujuei@mail2000.com.tw Tri-Service General Hospital Division of Nephrology, Department of Internal Medicine Taipei Taiwan -

Co-Author 4 *

Che Wei Liu Petergates38@gmail.com Cathay General Hospital Department of Orthopedics Taipei Taiwan -

Co-Author 5 *

Shun-Neng Hsu h720127@gmail.com Tri-Service General Hospital Division of Nephrology, Department of Internal Medicine Taipei Taiwan -

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Co-Author 9 *

Co-Author 10 *

Presenting Author

Presenting Author's First Name

Jing-Huan

Presenting Author's Last Name

Liao

Presenting Author's Email Address

joepoe168@gmail.com

Presenting Author's Country

Taiwan

Abstract Content

Abstract Title

Comparative Effectiveness and Safety of Bisphosphonates versus Denosumab in Non-Dialysis Stage 3-5 Chronic Kidney Disease

Introduction *

Importance: Chronic kidney disease (CKD) stages 3 to 5 is associated with increased fracture risk, yet comparative data on the effectiveness and safety of antiresorptive therapies in patients with non-dialysis CKD remain limited. Objective: To compare fracture, cardiovascular, renal, electrolyte, and mortality outcomes associated with bisphosphonates versus denosumab in adults with non-dialysis CKD stages 3 to 5.

Methods *

Design: Retrospective propensity score-matched (PSM) cohort study using the TriNetX Global Collaborative Network. Setting and Participants: Adults with non-dialysis CKD stages 3 to 5 who newly initiated bisphosphonates or denosumab between 2010 and 2020 were included. After 1:1 propensity score matching, 2561 patients were included in each group. Exposure: Bisphosphonates versus Denosumab.

Results *

Main Outcomes and Measures: Major osteoporotic fracture (MOF), major adverse cardiovascular events (MACE), death, composite renal outcome (acute kidney injury [AKI] and end-stage kidney disease [ESKD]), hyperkalemia, hypocalcemia, and longitudinal change in estimated glomerular filtration rate (eGFR). Results: In this matched cohort of 5122 adults with non-dialysis CKD stages 3 to 5, bisphosphonates and denosumab were associated with similar risks of MOF, MACE, death, and composite renal outcomes at 3 years. Bisphosphonate use was associated with lower risks of hyperkalemia and hypocalcemia. At 5 years, overall risks of MOF, MACE, death, and renal outcomes remained similar between groups, although bisphosphonates were additionally associated with a lower risk of spine fracture. Longitudinal decline in eGFR did not differ significantly between groups during follow-up

Conclusions *

Conclusions: Among adults with non-dialysis CKD stages 3 to 5, bisphosphonates and denosumab were associated with comparable overall fracture, cardiovascular, renal, and mortality outcomes. Compared with denosumab, bisphosphonates were associated with lower risks of hypocalcemia and hyperkalemia, supporting their consideration as a reasonable antiresorptive option in this population.

Keywords

Antiresorptive therapy, bisphosphonates, chronic kidney disease, denosumab, fracture, renal outcome

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