Table 3. Summary of Recommended Anti-osteoporosis Medication for CKD Patients.

Drug	Dosage	FDA-approved eGFR cutoffs	Effects on mineral metabolism
Alendronate	70 mg PO once weekly	eGFR > 35 mL/min	Hypocalcemia, hypophosphatemia
Ibandronate	150 mg PO once monthly or 3 mg IV every 3 mo	eGFR > 30 mL/min	-
Risendronate	5 mg PO daily or 35 mg PO weekly	eGFR > 30 mL/min	Hypocalcemia, hypophosphatemia, increased PTH levels
Abaloparatide	80 µg subcutaneously once daily	Any eGFR, not studied in ESRD	Hypercalcemia, hypercalciuria
Teriparatide	20–40 µg subcutaneous daily	eGFR > 35 mL/min	Hypercalcemia, hypocalcemia, hypercalciuria
Denosumab	60 mg subcutaneous every 6 mo	Any eGFR	Hypocalcemia, hypophosphatemia
Romosozumab	210 mg subcutaneous monthly	Not studied in CKD	-

CKD: chronic kidney disease, FDA: Food and Drug Administration, eGFR: estimated glomerular filtration rate, PO: per oral, IV: intravenous, -: unknown, PTH: parathyroid hormone, ESRD: end-stage renal disease.