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Perturbations in bone and mineral metabolism associated with chronic kidney disease (CKD) present a nuanced challenge, particularly in the context of their implications for fracture susceptibility in the pediatric demographic. Despite the well-established escalation of fracture risk in adults afflicted with end-stage renal disease, the extant scientific literature addressing this phenomenon in pediatric cohorts remains notably limited.Within this framework, we present the case of a 16-year-old adolescent devoid of significant medical antecedents, admitted to our facility due to terminal chronic kidney disease of indeterminate etiology. The diagnosis was conclusively established following pronounced manifestations of mineral and bone disorders, exemplified by a bilateral fracture involving both femoral necks.