**5. Conclusion**

CKD is not a single disease but a kind of syndrome. Thus, hypertension, obesity, atheroscle‐ rosis, gout, nephrolithiasis and life style are highly linked to the pathogenesis and the development of CKD. Diabetic nephropathy and hypertensive nephropathy are commonly observed in CKD, and these are probably at high risk for fracture. Because prevalence of CKD and osteoporosis increases in parallel with age, aged people often suffer from both disorders. Nowadays, CKD has been established as a risk factor for fragility fracture independent of age and BMD. Not only CKD progression but also bone loss is associated with mortality [61-63]. Thus, bone should be cared in early stages of CKD, at least followed by guidelines [42, 65]. Since bisphosphonates are not recommended in ESKD patients, future work is necessary to establish treatment of osteoporosis or osteopenia complicated with ESKD.
