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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Veröffentlicht in:Diabetic medicine Jg. 24; H. 1; S. 91 - 93
Hauptverfasser: Rigalleau, V., Lasseur, C., Raffaitin, C., Perlemoine, C., Barthe, N., Chauveau, P., Aparicio, M., Combe, C., Gin, H.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Oxford, UK Blackwell Publishing Ltd 01.01.2007
Blackwell
Schlagworte:
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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Zusammenfassung: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.
Bibliographie:istex:6210612535DE006EDFAC78742403A8DC257847BC
ArticleID:DME2026
ark:/67375/WNG-W4B0W4GF-4
ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0742-3071
1464-5491
DOI:10.1111/j.1464-5491.2007.02026.x