Profile of chronic kidney disease related-mineral bone disorders in newly diagnosed advanced predialysis diabetic kidney disease patients: A hospital based cross-sectional study

Ray, Sayantan; Beatrice, Anne M; Ghosh, Alakendu; Pramanik, Subhodip; Bhattacharjee, Rana; Ghosh, Sujoy; Raychaudhury, Arpita; Mukhopadhyay, Satinath; Chowdhury, Subhankar

doi:10.1016/j.dsx.2017.07.019

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…The association between TH, FN BMD, and GF confirms that good kidney function is crucial for cortical bone retention. PTH negatively correlated with LS, TH, and FN BMD, an observation that again tallies with previously published data [54, 55]. Total serum ALP correlated negatively with LS, FN, and DR BMD, again confirming previous findings [56, 57].…”

Section: Discussionsupporting

confidence: 91%

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

Kratochvílová

Brunová

Wohl

et al. 2019

Journal of Diabetes Research

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Posttransplant osteoporosis, which evolves from preexisting bone pathologies, represents a serious complication with deteriorating consequences. The aim of our study was to evaluate epidemiological data on bone mineral density (BMD) in subjects with type 1 diabetes (T1DM) in advanced stages of diabetic nephropathy indicated for simultaneous pancreas-kidney transplantation (SPK). We retrospectively compiled biochemical and densitometrical data from 177 patients with T1DM at CKD (chronic kidney disease) stages G4-G5 (115 men, 62 women, median age 40 yr, diabetes duration 23 yr) enrolled on waiting list for SPK for the first time between the years 2011 and 2016. Median Z-scores were as follows: lumbar spine (LS): -0.8 [interquartile range -1.75 to 0.1]; total hip (TH): -1.2 [-1.75 to -0.6]; femoral neck (FN): -1.2 [-1.9 to -0.7]; and distal radius (DR): -0.8 [-1.4 to -0.1]. We noted a gender difference in LS, with worse results for men (-1.1 vs. -0.3) even after adjusting for BMI (body mass index) and glomerular filtration (p<0.001). Osteoporotic and osteopenic ranges (based on T-scores) for all major sites were 27.7% and 56.5%, respectively, with similar results across both genders. Women had a significantly higher proportion of normal BMD in LS than men (67.7 vs. 49.4%, p<0.05). Patients with T1DM at CKD stages G4-G5 exhibited serious BMD impairment despite their young age. Men surprisingly displayed lower Z-scores and higher percentages of pathological BMD values in LS than women did. The introduction of adequate preventive measures during the advanced stages of diabetic nephropathy to prevent bone loss is recommended.

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Section: Discussionsupporting

confidence: 91%

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

Kratochvílová

Brunová

Wohl

et al. 2019

Journal of Diabetes Research

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“…A recent article by Ray et al [71] investigated the profile of CKD related-mineral bone disorders in 72 newly diagnosed DN patients with CKD stage 4 and 5. Vitamin D level was <20 ng/mL in 65.72% of them.…”

Section: Vitamin D and Diabetes In Kidney Diseasesmentioning

confidence: 99%

Role of Vitamin D Status in Diabetic Patients with Renal Disease

et al. 2019

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Diabetes mellitus (DM) poses a major public health problem worldwide, with ever-increasing incidence and prevalence in recent years. The Institute for Alternative Futures (IAF) expects that the total number of people with type 1 and type 2 DM in the United States will increase by 54%, from 19,629,000 to 54,913,000 people, between 2015 and 2030. Diabetic Nephropathy (DN) affects about one-third of patients with DM and currently ranks as the first cause of end-stage kidney disease in the Western world. The complexity of interactions of Vitamin D is directly related with progressive long-term changes implicated in the worsening of renal function. These changes result in a dysregulation of the vitamin D-dependent pathways. Various studies demonstrated a pivotal role of Vitamin D supplementation in regression of albuminuria and glomerulosclerosis, contrasting the increase of glomerular basement membrane thickening and podocyte effacement, with better renal and cardiovascular outcomes. The homeostasis and regulation of the nephron’s function are absolutely dependent from the cross-talk between endothelium and podocytes. Even if growing evidence proves that vitamin D may have antiproteinuric, anti-inflammatory and renoprotective effects in patients with DN, it is still worth investigating these aspects with both more in vitro studies and randomized controlled trials in larger patient series and with adequate follow-up to confirm the effects of long-term vitamin D analogue supplementation in DN and to evaluate the effectiveness of this therapy and the appropriate dosage.

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“…Consequently, hypocalcaemia occurs and stimulates PTH synthesis. This imbalance, due to the increase of the PTH, increases calcium withdrawal from bone tissue, making it fragile and prone to fractures …”

Section: Discussionmentioning

confidence: 99%

Albuminuria and low bone mineral density in paediatric patients with type 1 diabetes

Souza

Gomes

Oliveira

et al. 2018

J Paediatrics Child Health

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Profile of chronic kidney disease related-mineral bone disorders in newly diagnosed advanced predialysis diabetic kidney disease patients: A hospital based cross-sectional study

Cited by 14 publications

References 26 publications

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

Role of Vitamin D Status in Diabetic Patients with Renal Disease

Albuminuria and low bone mineral density in paediatric patients with type 1 diabetes

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