Patients with advanced chronic kidney disease (eGFR <30 ml/min/1.73="" m2),="" including="" dialysis-dependent="" patients,="" are="" at="" greater="" risk="" of="" severe="" hypocalcemia="" following="" prolia="" administration.="" severe="" hypocalcemia="" resulting="" in="" hospitalization,="" life-threatening="" events="" and="" fatal="" cases="" have="" been="" reported.="">
The presence of chronic kidney disease-mineral bone disorder (CKD-MBD) markedly increases the risk of hypocalcemia in these patients.
Prior to initiating Prolia in patients with advanced chronic kidney disease, evaluate for the presence of CKD-MBD. Treatment with Prolia in these patients should be supervised by a healthcare provider with expertise in the diagnosis and management of CKD-MBD.

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