Kidney Week

Abstract: FR-PO0417

Alterations in Bone and Mineral Metabolism in AKI: A Scoping Review and Evidence Map

Session Information

• AKI: Biomarkers, Diagnostics, and Risk Prediction
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Trakarnvanich, Thanphisit, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Thanphisit Trakarnvanich, MD

• Kittiweerawong, Wiphat, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Wiphat Kittiweerawong, MD

• Ostermann, Marlies, Guy's and St Thomas' NHS Foundation Trust, London, England, United Kingdom

Marlies Ostermann, MD, PhD

• Lumlertgul, Nuttha, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Nuttha Lumlertgul, MD, PhD

Background

Acute kidney injury (AKI) disrupts bone and mineral metabolism (BMM), but existing evidence remains fragmented. This scoping review mapped studies on BMM changes and related outcomes in patients at risk for, during, and after AKI.

Methods

We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov from inception to March 31, 2026. Eligible studies included adult or pediatric patients at risk for or diagnosed with AKI and reported at least one BMM parameter, including calcium, phosphate, magnesium, vitamin D, parathyroid hormone, fibroblast growth factor-23, or bone markers. The explored themes were the impact of AKI and RRT on BMM parameters, associated outcomes and available interventions.

Results

Among 5,716 abstracts screened, 185 studies were included. Prospective (45.2%) and retrospective cohort studies (41.4%) were the predominant designs, while randomized controlled trials (5.9%) remained limited. Adults were studied more frequently (91.4%) than pediatric cohorts (8.6%). The most frequently assessed biomarkers were phosphate (69%), total calcium (54%), ionized calcium (26%), PTH (27%), vitamin D (23%), and fibroblast growth factor-23 (22%). Conversely, bone turnover markers (2.7%), imaging (1.1%), and histology (0.5%) were rarely studied. Research primarily focused on the AKI period (82.3%), followed by pre-AKI (18.3%) and post-AKI follow-up periods (4.8%). Mortality was the most commonly reported clinical outcome (43%). Notably, only 3% of studies investigated the incidence of fractures or osteopenia associated with AKI.

Conclusion

Current evidence mainly focuses on short-term outcomes, especially mortality. Prospective and mechanistic studies are needed to clarify long-term consequences of mineral-bone axis disturbances in AKI and RRT populations.