Abstract:Hepatic osteodystrophy (HOD) is a metabolic bone disorder that occurs in patients with chronic liver disease or following liver transplantation, and is primarily characterized by osteoporosis and/or osteomalacia. Owing to the heterogeneous etiologies of chronic liver diseases, HOD exhibits substantial clinical heterogeneity, making early diagnosis challenging and leading to frequent underrecognition in clinical practice. To date, no universally accepted guideline is available for the diagnosis and management of HOD. The Chinese Medical Association's Medical Cell Biology Branch, Jiangsu Research Hospital Society, Jiangsu Developmental Biology Society, and Jiangsu Surgical Physicians Association convened a multidisciplinary panel of experts in hepatology, orthopedics, radiology, laboratory medicine, and basic medical sciences. Based on a systematic review of the latest national and international evidence and informed by current clinical practice in China, the panel developed 31 expert recommendations addressing key issues, including the epidemiology, risk factors, pathogenesis, screening and prevention, diagnosis and differential diagnosis, treatment, and follow-up management of HOD, and formulated the Chinese expert consensus on the diagnosis and management of hepatic osteodystrophy (2026 edition). This consensus aims to provide evidence-informed recommendations for the standardized screening, diagnosis, treatment, and long-term management of HOD, thereby improving clinical outcomes and quality of life in affected patients.