Pathogenesis of Compromised Bone Quality and Mechanics in Chronic Kidney Disease

Inclusion Criteria: * Chronic kidney disease stage 3, 4 or 5 * Stable dose of vitamin D for 2-months Exclusion Criteria: * Dialysis * Current use or treatment in the past one year with oral or inhaled glucocorticoids for more than 90 days. * Current use or treatment in the past one year with sex hormone/SERM therapy for more than 30 days. * Any use of bisphosphonates. * Use of anti-osteoporosis therapies (denosumab, teriparatide, calcitonin or anti-sclerostin antibodies) in last 2 years. * Any solid organ transplant or bone marrow transplant (Not including skin or cornea). * Patients on non-aspirin anticoagulants that cannot be reasonably held for biopsy. * Any cancers within 5-yrs of diagnosis that were metastatic to bone, and that are not in complete remission * Any history of leukemia, multiple myeloma, lymphoma, amyloid or paraproteinemias. * Any congenital or acquired collagen of bone diseases other than osteoporosis or renal osteodystrophy (Including but not limited to: Osteogenesis Imperfecta, X-Linked Hypophosphatemic Rickets, Pagets or Cushings Disease). * History of Primary Hyperparathyroidism within 2-years of Parathyroidectomy. * Hypoparathyroidism - primary or post-surgical * Hyperthyroidism - if untreated and not on stable dose of medication for 6 months * Hypothyroidism - if untreated and not on stable dose of medication for 6 months * Non-ambulatory * Bilateral lower extremity amputations. * Weight \>300 lbs. * Medical disease - end stage heart, end stage l…