Osteoporosis is a crucial complication in patients with chronic kidney disease (CKD), similar to that in the general population. Although romosozumab, a monoclonal antibody targeting sclerostin, has been administered for patients with CKD, its clinical effectiveness in these patients, especially in patients on hemodialysis (HD), remains to be studied. Herein, we report the case of a 42-year-old man on HD who developed severe osteoporosis. Serum calcium levels were extremely high, bone metabolic markers were abnormal, and the patient had pathological fractures. The bone biopsy indicated a bone metabolism disorder and high bone turnover. We administered romosozumab once a month as an intervention for bone alteration. Through the 10-month usage, bone metabolic markers improved, and the decrease in bone mineral density was ameliorated. We hypothesized that romosozumab could be a therapeutic option for osteoporosis in patients undergoing HD, especially in those with bone mineralization disorders.

骨质疏松症是慢性肾脏病 (CKD) 患者的重要并发症，与普通人群相似。尽管 romosozumab 是一种针对硬化蛋白的单克隆抗体，已用于 CKD 患者，但其在这些患者中的临床疗效，尤其是在血液透析 (HD) 患者中的疗效仍有待研究。在此，我们报告了一名患有严重骨质疏松症的 42 岁 HD 男性病例。血清钙水平极高，骨代谢指标异常，患者有病理性骨折。骨活检显示骨代谢紊乱和高骨转换。我们每月使用一次 romosozumab 作为骨改变的干预措施。通过 10 个月的使用，骨代谢指标得到改善，骨矿物质密度的下降得到改善。