Bone loss in diabetic patients with chronic kidney disease

Objective We investigated whether loss of bone is detectable during follow‐up of diabetic patients with chronic kidney disease (CKD). Research design and methods In 40 initially non‐dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m2 or albumin excretion...

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Vydáno v:	Diabetic medicine Ročník 24; číslo 1; s. 91 - 93
Hlavní autoři:	Rigalleau, V., Lasseur, C., Raffaitin, C., Perlemoine, C., Barthe, N., Chauveau, P., Aparicio, M., Combe, C., Gin, H.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Oxford, UK Blackwell Publishing Ltd 01.01.2007 Blackwell
Témata:	Adult Aged Aged, 80 and over Biological and medical sciences Body Mass Index Bone Density - physiology Bone Diseases, Metabolic - etiology Bone Diseases, Metabolic - physiopathology bone mineral density chronic kidney disease diabetes Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 2 - complications Diabetes. Impaired glucose tolerance Diseases of the osteoarticular system Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Femoral Neck Fractures - etiology Follow-Up Studies Humans Kidney Failure, Chronic - complications Male Medical sciences Middle Aged osteopaenia Osteoporosis. Osteomalacia. Paget disease Risk Factors Endocrinopathy Kidney disease Human Urinary system disease osteopaenia Diabetes mellitus Renal failure Diseases of the osteoarticular system Bone mineral density Chronic kidney disease diabetes Osteopenia
ISSN:	0742-3071, 1464-5491
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Shrnutí:	Objective We investigated whether loss of bone is detectable during follow‐up of diabetic patients with chronic kidney disease (CKD). Research design and methods In 40 initially non‐dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m2 or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from 51Cr‐EDTA clearance) were measured at a 2‐year interval, and compared by paired t‐tests. Results The 40 patients, mainly with Type 2 diabetes (n = 28), were men (n = 28), aged 65 ± 11 years, with diabetes duration 18 ± 11 years. GFR was initially 38.0 (range 8–89) ml/min/1.73 m2. CKD progressed during follow‐up: eight started haemodialysis and GFR declined in the 32 others (P < 0.05 vs. initial). T‐scores for total body (initial −0.61 ± 1.11, final −1.11 ± 1.40; P < 0.001) and femoral neck (initial −1.88 ± 0.15, final −2.07 ± 0.15; P < 0.05) declined. Ten patients were osteopaenic at baseline (no osteoporosis), whereas most were osteopaenic (n = 21, P < 0.05) and five were osteoporotic at final assessment. The 16 patients who became osteopaenic or osteoporotic during follow‐up did not differ from the others for the type of diabetes, age, GFR, albumin excretion rate, HbA1c, GFR reduction and the requirement for dialysis during follow‐up. They were all men (P < 0.01 by chi‐squared test), with reduced initial total body T‐score (−1.20 ± 0.82, others −0.32 ± 1.13; P < 0.05) and a lower body mass index (24.6 ± 4.3; others 27.7 ± 4.3; P < 0.05). Conclusion Bone loss, especially in the femoral neck, is progressive in diabetic patients with CKD.
Bibliografie:	istex:6210612535DE006EDFAC78742403A8DC257847BC ArticleID:DME2026 ark:/67375/WNG-W4B0W4GF-4 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0742-3071 1464-5491
DOI:	10.1111/j.1464-5491.2007.02026.x