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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Vydané v:	Diabetic medicine Ročník 24; číslo 1; s. 91 - 93
Hlavní autori:	Rigalleau, V., Lasseur, C., Raffaitin, C., Perlemoine, C., Barthe, N., Chauveau, P., Aparicio, M., Combe, C., Gin, H.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Oxford, UK Blackwell Publishing Ltd 01.01.2007 Blackwell
Predmet:	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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Abstract	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.
AbstractList	AbstractObjectiveWe investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD).Research design and methodsIn 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.ResultsThe 40 patients, mainly with Type 2 diabetes (n = 28), were men (n = 28), aged 65 plus or minus 11 years, with diabetes duration 18 plus or minus 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 plus or minus 1.11, final -1.11 plus or minus 1.40; P < 0.001) and femoral neck (initial -1.88 plus or minus 0.15, final -2.07 plus or minus 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 plus or minus 0.82, others -0.32 plus or minus 1.13; P < 0.05) and a lower body mass index (24.6 plus or minus 4.3; others 27.7 plus or minus 4.3; P < 0.05).ConclusionBone loss, especially in the femoral neck, is progressive in diabetic patients with CKD.Diabet. Med. 24, 91-93 (2007) We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD).OBJECTIVEWe investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD).In 40 initially non-dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m(2) or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from (51)Cr-EDTA clearance) were measured at a 2-year interval, and compared by paired t-tests.RESEARCH DESIGN AND METHODSIn 40 initially non-dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m(2) or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from (51)Cr-EDTA clearance) were measured at a 2-year interval, and compared by paired t-tests.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 m(2). 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, HbA(1c), 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).RESULTSThe 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 m(2). 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, HbA(1c), 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).Bone loss, especially in the femoral neck, is progressive in diabetic patients with CKD.CONCLUSIONBone loss, especially in the femoral neck, is progressive in diabetic patients with CKD. 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. We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD). In 40 initially non-dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m(2) or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from (51)Cr-EDTA clearance) were measured at a 2-year interval, and compared by paired t-tests. 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 m(2). 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, HbA(1c), 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). Bone loss, especially in the femoral neck, is progressive in diabetic patients with CKD. 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 m 2 or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from 51 Cr‐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 m 2 . 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, HbA 1c , 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.
Author	Chauveau, P. Combe, C. Barthe, N. Raffaitin, C. Lasseur, C. Perlemoine, C. Aparicio, M. Rigalleau, V. Gin, H.
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Keywords	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
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References	Rakic V, Davis WA, Chubb SAP, Islam FMA, Prince RL, Davis TME. Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study. Diabetologia 2006; 49: 863-871. Rix M, Andreassen H, Eskildsen P, Langdahl B, Olgaard K. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int 1999; 56: 1084-1093. Hruska KA. Renal osteodystrophy. Baillieres Clin Endocrinol Metab 1997; 11: 165-194. Goliat E, Marusza W, Ostrowski K, Lipinska A. Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency. Pol Arch Med Wewn 1998; 100: 111-118. Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH. Progression of diabetic nephropathy. Kidney Int 2001; 59: 702-709. Pei Y, Hercz G, Greenwood C, Segre G, Manuel A, Saiphoo C et al. Renal osteodystrophy in diabetic patients. Kidney Int 1993; 44: 159-164. Spasovski GB, Bervoets AR, Behets GJ, Ivanovski N, Sikole A, Dams G et al. Spectrum of renal bone disease in end-stage renal failure patients not yet on dialysis. Nephrol Dial Transplant 2003; 18: 1159-1166. Tuominen JT, Impivaara O, Puukka P, Ronnemaa T. Bone mineral density in patients with type 1 and type 2 diabetes. Diabetes Care 1999; 22: 1196-1200. Clausen P, Feldt-Rasmussen B, Jacobsen P, Rossing K, Parving HH, Nielsen PK et al. Microalbuminuria as an early indicator of osteopenia in male insulin-dependent diabetic patients. Diabet Med 1997; 14: 1038-1043. Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005; 20: 1185-1194. Ahmed LA, Joakimsen RM, Berntsen GK, Fonnebo V, Schirmer H. Diabetes mellitus and the risk of non-vertebral fractures: the Tromso study. Osteoporos Int 2006; 17: 495-500. Vestergaard P, Rejnmark L, Mosekilde L. Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral anti-diabetic medication on relative fracture risk. Diabetologia 2005; 48: 1292-1299. Kaji H, Suzuki M, Yano S, Sugimoto T, Chihara K, Hattori S et al. Risk factors for hip fracture in hemodialysis patients. Am J Nephrol 2002; 22: 325-331. Strotmeyer ES, Cauley JA, Schwartz AV, Nevitt MC, Resnick HE, Bauer DC et al. Non-traumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study. Arch Intern Med 2005; 165: 1612-1617. Nicodemus KK, Folsom AR; Iowa Women's Health Study. Type 1 and type 2 diabetes and incident hip fractures in post-menopausal women. Diabetes Care 2001; 24: 1192-1197. Miao J, Brismar K, Nyren O, Ugarph-Morawski A, Ye W. Elevated hip fracture risk in type 1 diabetic patients: a population-based cohort study in Sweden. Diabetes Care 2005; 28: 2850-2855. Rossing K, Christensen PK, Hovind P, Tarnow L, Rossing P, Parving HH. Progression of nephropathy in type 2 diabetic patients. Kidney Int 2004; 66: 1596-1605. De Liefde II, Van Der Klift M, De Laet CE, Van Daele PL, Hofman A, Pols HA. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int 2005; 16: 1713-1720. Nishitani H, Miki T, Morii H, Nishizawa Y, Ishimura E, Hagiwara S et al. Decreased bone mineral density in diabetic patients on hemodialysis. Contrib Nephrol 1991; 90: 223-227. 2004; 66 1997; 11 2005; 165 1993; 44 2006; 49 1997; 14 2006; 17 2002; 22 1999; 56 1991; 90 1999; 22 2005; 20 2001; 59 2003; 18 1998; 100 2005; 48 2005; 16 2005; 28 2001; 24 e_1_2_8_16_2 e_1_2_8_17_2 e_1_2_8_18_2 e_1_2_8_19_2 e_1_2_8_13_2 e_1_2_8_14_2 e_1_2_8_15_2 e_1_2_8_9_2 e_1_2_8_2_2 e_1_2_8_4_2 Goliat E (e_1_2_8_12_2) 1998; 100 e_1_2_8_3_2 e_1_2_8_6_2 e_1_2_8_5_2 e_1_2_8_8_2 e_1_2_8_7_2 e_1_2_8_20_2 e_1_2_8_10_2 e_1_2_8_11_2
References_xml	– reference: Nicodemus KK, Folsom AR; Iowa Women's Health Study. Type 1 and type 2 diabetes and incident hip fractures in post-menopausal women. Diabetes Care 2001; 24: 1192-1197. – reference: Vestergaard P, Rejnmark L, Mosekilde L. Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral anti-diabetic medication on relative fracture risk. Diabetologia 2005; 48: 1292-1299. – reference: Tuominen JT, Impivaara O, Puukka P, Ronnemaa T. Bone mineral density in patients with type 1 and type 2 diabetes. Diabetes Care 1999; 22: 1196-1200. – reference: Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH. Progression of diabetic nephropathy. Kidney Int 2001; 59: 702-709. – reference: Hruska KA. Renal osteodystrophy. Baillieres Clin Endocrinol Metab 1997; 11: 165-194. – reference: Rakic V, Davis WA, Chubb SAP, Islam FMA, Prince RL, Davis TME. Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study. Diabetologia 2006; 49: 863-871. – reference: Goliat E, Marusza W, Ostrowski K, Lipinska A. Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency. Pol Arch Med Wewn 1998; 100: 111-118. – reference: Ahmed LA, Joakimsen RM, Berntsen GK, Fonnebo V, Schirmer H. Diabetes mellitus and the risk of non-vertebral fractures: the Tromso study. Osteoporos Int 2006; 17: 495-500. – reference: Rossing K, Christensen PK, Hovind P, Tarnow L, Rossing P, Parving HH. Progression of nephropathy in type 2 diabetic patients. Kidney Int 2004; 66: 1596-1605. – reference: De Liefde II, Van Der Klift M, De Laet CE, Van Daele PL, Hofman A, Pols HA. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int 2005; 16: 1713-1720. – reference: Spasovski GB, Bervoets AR, Behets GJ, Ivanovski N, Sikole A, Dams G et al. Spectrum of renal bone disease in end-stage renal failure patients not yet on dialysis. Nephrol Dial Transplant 2003; 18: 1159-1166. – reference: Miao J, Brismar K, Nyren O, Ugarph-Morawski A, Ye W. Elevated hip fracture risk in type 1 diabetic patients: a population-based cohort study in Sweden. Diabetes Care 2005; 28: 2850-2855. – reference: Rix M, Andreassen H, Eskildsen P, Langdahl B, Olgaard K. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int 1999; 56: 1084-1093. – reference: Kaji H, Suzuki M, Yano S, Sugimoto T, Chihara K, Hattori S et al. Risk factors for hip fracture in hemodialysis patients. Am J Nephrol 2002; 22: 325-331. – reference: Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005; 20: 1185-1194. – reference: Nishitani H, Miki T, Morii H, Nishizawa Y, Ishimura E, Hagiwara S et al. Decreased bone mineral density in diabetic patients on hemodialysis. Contrib Nephrol 1991; 90: 223-227. – reference: Pei Y, Hercz G, Greenwood C, Segre G, Manuel A, Saiphoo C et al. Renal osteodystrophy in diabetic patients. Kidney Int 1993; 44: 159-164. – reference: Clausen P, Feldt-Rasmussen B, Jacobsen P, Rossing K, Parving HH, Nielsen PK et al. Microalbuminuria as an early indicator of osteopenia in male insulin-dependent diabetic patients. Diabet Med 1997; 14: 1038-1043. – reference: Strotmeyer ES, Cauley JA, Schwartz AV, Nevitt MC, Resnick HE, Bauer DC et al. Non-traumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study. Arch Intern Med 2005; 165: 1612-1617. – volume: 66 start-page: 1596 year: 2004 end-page: 1605 article-title: Progression of nephropathy in type 2 diabetic patients publication-title: Kidney Int – volume: 56 start-page: 1084 year: 1999 end-page: 1093 article-title: Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure publication-title: Kidney Int – volume: 17 start-page: 495 year: 2006 end-page: 500 article-title: Diabetes mellitus and the risk of non‐vertebral fractures: the Tromso study publication-title: Osteoporos Int – volume: 16 start-page: 1713 year: 2005 end-page: 1720 article-title: Bone mineral density and fracture risk in type‐2 diabetes mellitus: the Rotterdam Study publication-title: Osteoporos Int – volume: 22 start-page: 325 year: 2002 end-page: 331 article-title: Risk factors for hip fracture in hemodialysis patients publication-title: Am J Nephrol – volume: 28 start-page: 2850 year: 2005 end-page: 2855 article-title: Elevated hip fracture risk in type 1 diabetic patients: a population‐based cohort study in Sweden publication-title: Diabetes Care – volume: 24 start-page: 1192 year: 2001 end-page: 1197 article-title: Iowa Women's Health Study. Type 1 and type 2 diabetes and incident hip fractures in post‐menopausal women publication-title: Diabetes Care – volume: 90 start-page: 223 year: 1991 end-page: 227 article-title: Decreased bone mineral density in diabetic patients on hemodialysis publication-title: Contrib Nephrol – volume: 18 start-page: 1159 year: 2003 end-page: 1166 article-title: Spectrum of renal bone disease in end‐stage renal failure patients not yet on dialysis publication-title: Nephrol Dial Transplant – volume: 20 start-page: 1185 year: 2005 end-page: 1194 article-title: Predictive value of BMD for hip and other fractures publication-title: J Bone Miner Res – volume: 100 start-page: 111 year: 1998 end-page: 118 article-title: Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency publication-title: Pol Arch Med Wewn – volume: 44 start-page: 159 year: 1993 end-page: 164 article-title: Renal osteodystrophy in diabetic patients publication-title: Kidney Int – volume: 48 start-page: 1292 year: 2005 end-page: 1299 article-title: Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral anti‐diabetic medication on relative fracture risk publication-title: Diabetologia – volume: 22 start-page: 1196 year: 1999 end-page: 1200 article-title: Bone mineral density in patients with type 1 and type 2 diabetes publication-title: Diabetes Care – volume: 59 start-page: 702 year: 2001 end-page: 709 article-title: Progression of diabetic nephropathy publication-title: Kidney Int – volume: 165 start-page: 1612 year: 2005 end-page: 1617 article-title: Non‐traumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study publication-title: Arch Intern Med – volume: 14 start-page: 1038 year: 1997 end-page: 1043 article-title: Microalbuminuria as an early indicator of osteopenia in male insulin‐dependent diabetic patients publication-title: Diabet Med – volume: 11 start-page: 165 year: 1997 end-page: 194 article-title: Renal osteodystrophy publication-title: Baillieres Clin Endocrinol Metab – volume: 49 start-page: 863 year: 2006 end-page: 871 article-title: Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study publication-title: Diabetologia – ident: e_1_2_8_9_2 doi: 10.1111/j.1523-1755.2004.00925.x – ident: e_1_2_8_8_2 doi: 10.1046/j.1523-1755.2001.059002702.x – ident: e_1_2_8_17_2 doi: 10.1007/s00198-005-0013-x – volume: 100 start-page: 111 year: 1998 ident: e_1_2_8_12_2 article-title: Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency publication-title: Pol Arch Med Wewn – ident: e_1_2_8_15_2 doi: 10.1001/archinte.165.14.1612 – ident: e_1_2_8_18_2 doi: 10.1007/s00198-005-1909-1 – ident: e_1_2_8_5_2 doi: 10.1038/ki.1993.226 – ident: e_1_2_8_3_2 doi: 10.1159/000065222 – ident: e_1_2_8_2_2 doi: 10.1016/S0950-351X(97)80585-X – ident: e_1_2_8_13_2 doi: 10.1046/j.1523-1755.1999.00617.x – ident: e_1_2_8_4_2 doi: 10.1159/000420147 – ident: e_1_2_8_14_2 doi: 10.1359/JBMR.050304 – ident: e_1_2_8_6_2 doi: 10.1093/ndt/gfg116 – ident: e_1_2_8_16_2 doi: 10.2337/diacare.28.12.2850 – ident: e_1_2_8_11_2 doi: 10.2337/diacare.22.7.1196 – ident: e_1_2_8_19_2 doi: 10.1007/s00125-005-1786-3 – ident: e_1_2_8_7_2 doi: 10.1002/(SICI)1096-9136(199712)14:12<1038::AID-DIA509>3.0.CO;2-1 – ident: e_1_2_8_20_2 doi: 10.2337/diacare.24.7.1192 – ident: e_1_2_8_10_2 doi: 10.1007/s00125-006-0154-2
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Snippet	Objective We investigated whether loss of bone is detectable during follow‐up of diabetic patients with chronic kidney disease (CKD). Research design and... Objective We investigated whether loss of bone is detectable during follow‐up of diabetic patients with chronic kidney disease (CKD). Research design and... We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD). In 40 initially non-dialysed... AbstractObjectiveWe investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD).Research design and... We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD).OBJECTIVEWe investigated whether...
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SubjectTerms	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
Title	Bone loss in diabetic patients with chronic kidney disease
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