Sabina Chaudhary Hauge1, Morten Frost2, Ditte Hansen3,4. 1. Department of Nephrology, Herlev Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. sabina.chaudhary.hauge@regionh.dk. 2. Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 5000, Odense C, Denmark. 3. Department of Nephrology, Herlev Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. 4. Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.
Abstract
PURPOSE OF REVIEW: Both diabetes and kidney disease associate with the development of bone disease and an increased risk of fragility fractures. The etiologies of bone disease in patients with diabetic kidney disease (DKD) are multiple and complex. This review explores the association between DKD and bone disease and discusses how the presence of both diabetes and kidney disease may impair bone quality and increase fracture risk. Diagnostic tools as well as future research areas are also discussed. RECENT FINDINGS: Patients with DKD have an increased risk of fragility fracture, most pronounced in patients with type 1 diabetes, and in DKD a high prevalence of adynamic bone disease is found. Recent studies have demonstrated disturbances in the interplay between bone regulating factors in DKD, such as relative hypoparathyroidism and alterations of bone-derived hormones including fibroblast growth factor-23 (FGF-23), sclerostin and klotho, which lead to bone disease. This review examines the current knowledge on bone disease in patients with DKD, clinical considerations for patient care, as well as subjects for future research.
PURPOSE OF REVIEW: Both diabetes and kidney disease associate with the development of bone disease and an increased risk of fragility fractures. The etiologies of bone disease in patients with diabetic kidney disease (DKD) are multiple and complex. This review explores the association between DKD and bone disease and discusses how the presence of both diabetes and kidney disease may impair bone quality and increase fracture risk. Diagnostic tools as well as future research areas are also discussed. RECENT FINDINGS: Patients with DKD have an increased risk of fragility fracture, most pronounced in patients with type 1 diabetes, and in DKD a high prevalence of adynamic bone disease is found. Recent studies have demonstrated disturbances in the interplay between bone regulating factors in DKD, such as relative hypoparathyroidism and alterations of bone-derived hormones including fibroblast growth factor-23 (FGF-23), sclerostin and klotho, which lead to bone disease. This review examines the current knowledge on bone disease in patients with DKD, clinical considerations for patient care, as well as subjects for future research.
Authors: Chang Seong Kim; Hong Sang Choi; Eun Hui Bae; Seong Kwon Ma; Bongseong Kim; Kyung-Do Han; Soo Wan Kim Journal: Front Med (Lausanne) Date: 2022-07-28