Thongprayoon C, et al. - Using MEDLINE, EMBASE, and Cochrane Database, authors evaluated the incidence of denosumab-associated hypocalcemia and impacts of denosumab on bone mineral density (BMD) in end-stage renal disease (ESRD) patients. Six observational studies with a total of 84 ESRD patients were enrolled. The estimated incidence of denosumab-associated hypocalcemia in dialysis patients was found to be 42%. Findings suggested significant reductions in alkaline phosphatase (ALP) and parathyroid hormone (PTH) and a significant increase in BMD from baseline to post-treatment course, despite the absence of differences in serum calcium and phosphate.