PTH and Marchiafava-Bignami disease: Prior to the use of antiresorptive medications in CKD, it is important to evaluate CKD-MBD by measuring baseline serum calcium, phosphate, PTH, alkaline phosphatase, and 25-hydroxyvitamin D. For osteoporosis, various medication options, including the primary agent nitrogen-containing bisphosphonates, are effective and convenient.