I have chronic kidney disease and Tymlos, Forteo and Evenity were all okay for kidneys. I wonder if your doctor is thinking only of Bisphosphonates like Reclast or Fosamax (alendronate) vs Prolia.

The thing is, for any of those drugs, unless you are in your 80's and can stay on Prolia, we all end up doing Reclast to prevent rebound and/or lock in gains from the other drugs.

I am doing a 20% dose of Reclast this week with IV hydration, slow infusion and tylenol, to minimize effect on kidneys. I did two years Tymlos (dose is adjustable) and 4 months Evenity. My scores were pretty bad but I had excellent gains.

If your bones aren't too bad, you could do Prolia, and you can do it for several years, but the longer you stay on it the harder it is to get off. When you stop, bone density goes down and fracture risk goes up quickly unless you do Reclast. If you only do 1-3 shots (a year and a half) alendronate might be used to stop the rebound and is gentler on the kidneys than Reclast.

This is all from my own experience and I hope you can discuss with an endocrinologist who also consults with your nephrologist! It depends on age, DEXA scores, kidney status and other health issues so I hope your doctors can individualize.