My primary care physician is the one pushing me to start Prolia. I have told him that I will give him my decision after conversing with my nephrologist (who is willing to consult with an endocrinologist at the hospital where she works). So the answer to your question is yes, my nephrologist is in the loop because I have been proactive about including her. My PCP was not going to get a second opinion, while I refuse to move forward without one.