Osteoporosis is one of the epidemics in modern aging societies. Epidemiological studies indicate that many patients with osteoporosis are also characterized by diminished glomerular filtration rate (GFR), which indicates various degrees of chronic kidney disease (CKD). On the other hand, the status of osteoporosis in the classification of mineral and bone disorders in CKD has not been well defined. In the present paper, we review the epidemiology of osteoporosis in the context of kidney failure, discuss tools used to diagnose osteoporosis in patients with CKD, present data on fracture risk in patients with kidney diseases, and describe the relationship between metabolic bone diseases and the development of vascular calcification. We also present current treatments in osteoporosis with special attention to the outcomes of these treatments in patients with low GFR.