Patients with chronic kidney disease (CKD) are at increased risk of fractures, and accurate assessment of this risk remains a major clinical challenge. Traditional tools such as bone mineral density and fracture risk assessment tool show limited predictive performance in CKD population. In recent years, novel approaches including trabecular bone score, vertebral fracture assessment, hip structural analysis, quantitative computed tomography, high-resolution peripheral quantitative computed tomography, artificial intelligence, and bone turnover markers have been introduced for fracture risk assessment. These emerging techniques provide more comprehensive evaluation strategies, yet their clinical utility remains to be fully validated. This review summarizes current research progress on fracture risk assessment methods in CKD patients and highlights potential directions for improving risk prediction in CKD population.

Patients with chronic kidney disease (CKD) are at increased risk of fractures, and accurate assessment of this risk remains a major clinical challenge. Traditional tools such as bone mineral density and fracture risk assessment tool show limited predictive performance in CKD population. In recent years, novel approaches including trabecular bone score, vertebral fracture assessment, hip structural analysis, quantitative computed tomography, high-resolution peripheral quantitative computed tomography, artificial intelligence, and bone turnover markers have been introduced for fracture risk assessment. These emerging techniques provide more comprehensive evaluation strategies, yet their clinical utility remains to be fully validated. This review summarizes current research progress on fracture risk assessment methods in CKD patients and highlights potential directions for improving risk prediction in CKD population.