In a prospective 2‐year study of 89 hemodialysis patients, baseline BSAP was strongly associated with loss of BMD cortical mass and volume.127 In prospective studies of patients with CKD before (n = 52) and after renal transplantation (n = 47), the microarchitectural and biochemical mechanisms of bone loss were examined by BTMs, DXA, and HR‐pQCT.108, 128 Higher levels of PTH, BSAP, osteocalcin, PINP, TRAP, and CTX predicted the loss of cortical area, density, and thickness, increase in cortical porosity, and decreased bone strength. Here, PTH is linked to chronic kidney disease.