OBJECTIVES: Abnormal bone mineral density (BMD) is common in chronic kidney disease (CKD) and related with higher risk of disease progression, cardiovascular disease, and mortality. The aim of this study was to assess BMD, its change overtime and association with body composition and biochemical parameters of mineraly metabolism. METHODS: This was a longitudinal study of patients with NDD-CKD (stages 3–5) undergoing interdisciplinary treatment at an outpatient Nephrology Clinic and instructed to follow a low protein diet. Dual energy X-ray absorptiometry (DXA) was performed to estimate body composition and BMD (T-score). Mineral metabolism parameters included parathormone (PTH), calcium, phosphorus and vitamin D. Glomerular filtration rate was estimated (eGFR) by the CKD-EPI equation. Osteopenia was defined as T-score < -1.0. Baseline and follow-up comparisons between groups with and without osteopenia were performed by two-way ANOVA. Correlations were adjusted by sex, age and eGFR. RESULTS: Forty-five patients (56% males) aged 64.4 ± 9.9 y and eGFR 31.4 ± 10.9 ml/min completed a follow-up of ∼3 years (2.7 ± 1.3). As expected, a reduction in renal function was observed (median = −1.10 ml/min; 95% CI: −8.8 to 0.64, P