Bone abnormalities in diabetic hemodialysis patients

Abstract

In patients with end stage renal disease, metabolic bone abnormalities are frequently seen. Diabetes may affect bone metabolism through various mechanisms, including hyperglycemia, insulin deficiency, and accumulation of advanced glycation end-products. Bone disease in hemodialysis patients with diabetes mellitus is characterized by low bone turnover, resulting from either impaired secretion of parathyroid hormone or osteoblast dysfunction. The prevalence rate of vertebral fractures in diabetic hemodialysis patients was 32%, which was greater than that of non-diabetic hemodialysis patients (13%). In non-diabetic hemodialysis patients, those with vertebral fracture showed significantly lower bone mineral density in either lumbar spine or distal one third of radius than the respective value in those without fracture. However, in diabetic hemodialysis patients, neither bone mineral density in lumbar spine nor distal one third of radius was significantly lower in those with vertebral fracture than in those without.