Precision Medicine Approaches to Renal Osteodystrophy

This study looks at personalized treatment approaches for kidney bone disease — a common complication of chronic kidney disease (CKD) where the bones weaken and break down, or sometimes form too slowly. Researchers want to understand how different bone-affecting medications should be chosen and monitored based on individual bone biology. **You may be eligible if...** - You are 18 or older with chronic kidney disease stage 3–5 (including those on dialysis or with a kidney transplant) - You are on maintenance hemodialysis for at least 3 months - You need treatment for kidney-related bone disease, hyperparathyroidism, or osteoporosis - Your bone markers meet specific thresholds for low or high bone turnover **You may NOT be eligible if...** - You received certain bone medications (bisphosphonates, denosumab, teriparatide, etc.) in the past 6 months (unless switching to a different class) - You are scheduled for a kidney transplant within the study period or received one within the past year - You have a bone disease unrelated to kidney disease (e.g., Paget's disease) - You are pregnant or breastfeeding - You weigh over 300 pounds (due to scanner limits) - You are allergic to tetracycline antibiotics Talk to your doctor to see if this trial is right for you.