Bone loss in diabetic patients with chronic kidney disease
Article first published online: 10 JAN 2007
Volume 24, Issue 1, pages 91–93, January 2007
How to Cite
Rigalleau, V., Lasseur, C., Raffaitin, C., Perlemoine, C., Barthe, N., Chauveau, P., Aparicio, M., Combe, C. and Gin, H. (2007), Bone loss in diabetic patients with chronic kidney disease. Diabetic Medicine, 24: 91–93. doi: 10.1111/j.1464-5491.2007.02026.x
- Issue published online: 10 JAN 2007
- Article first published online: 10 JAN 2007
- Accepted 10 August 2006
- bone mineral density;
- 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 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.