The management of CKD associated osteoporosis starts with life style management, ROD management and specific therapies as tested by serum BSAP. High bone turnover can be managed by either Bisphosphonates/Denosumab for eGFR >40 ml/1.73m2/min and Denosumab for lesser than this while low bone turnover disease requires anabolic agents. The gene discussed is PAX5; the disease is chronic kidney disease.