Fractures are a debilitating injury associated with extended rehabilitation, long-term pain, and considerable costs. Just half of patients with a hip fracture regain their mobility and their prefracture level of independence.1 As the population ages, predictions about increasing numbers of fractures are staggering: from 1.7 million fractures in 1990 to 6.3 million in 2050.2 Studies in patients with chronic kidney disease (CKD) stages 3 and 4 (CKD 3-4),3-6 on dialysis,7,8 and after transplantation9,10 all show that patients with CKD have a 2- to 100-fold increase in fracture risk compared to age- and sex-matched individuals without CKD.