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Preventing fractures in renal disease

Fragility Fractures of the spine, hips, wrists, shoulders, and pelvis are a leading cause of morbidity and can result in hospitalization, permanent disability, institutionalization, and even death. Persons on hemodialysis have a risk of fracture that is more than five times higher than sex- and age-matched individuals without chronic kidney disease.

Denosumab is a medication that is approved in Canada to reduce fragility fracture risk, but there have been few research studies on its efficacy and safety in hemodialysis.


Dr. Kristin Clemens proposed a large randomized pragmatic trial of denosumab in routine care hemodialysis centres to determine whether a denosumab care pathway vs. usual care can reduce the risk of fragility fracture in a high-risk population.

Dr. Kristin Clemens

PI: Dr. Kristin Clemens

Dr. Kristin Clemens is an Assistant Professor of Medicine and Epidemiology and Biostatistics at Western University, an Adjunct ICES Scientist, an Associate Scientist at Lawson Health Research Institute, a general endocrinologist at St. Joseph’s Hospital, and Medical Director of the Osteoporosis and Metabolic Bone Disease Program at St. Joseph’s Health Care London.

Dr. Clemens advances studies to improve the care and outcomes of patients living with complex endocrine diseases, particularly those with diabetes/metabolic bone disease and chronic kidney disease. She has experience with diverse research methods, including observational designs, patient-oriented research, surveys, and qualitative methodology.

Dr. Clemens has more than 60 peer-reviewed publications, has supervised more than 35 trainees in health research, and has acquired research grants from CIHR, the Kidney Foundation of Canada, AMOSO, Research Western, and the Schulich School of Medicine & Dentistry. She has received awards for both administrative leadership, and research (Diabetes Canada Junior Investigator Award 2017).