Precision Renal Osteodystrophy: What's Race Got to do With It?

PURPOSE OF REVIEW

To present race and ethnicity as evidence of the need for precision medicine in renal osteodystrophy.

RECENT FINDINGS

Previously described racial-ethnic differences in bone persist in recent data on fracture risk in the healthy and CKD populations. These differences have historically been noted between Black and White participants, but recent data suggests racial-ethnic differences in bone are more intricate than previously recognized. A reflection on skeletal differences within the general, non-CKD population, provides a context to better understand skeletal differences by race within CKD. Despite numerous studies demonstrating racial differences in skeletal microarchitecture, fracture risk and skeletal biomarkers, further evidence is needed to pinpoint the etiology of racial differences and to allow precision treatment that reflects the individual patient, regardless of race. In the end, race is currently our most saliant example of the need for a precision medicine approach to the treatment of renal osteodystrophy.