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Understanding Bone Disease in Patients with Diabetic Kidney Disease: a Narrative Review

  • Bone and Diabetes (A Schwartz and P Vestergaard, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

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.

Summary

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.

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  1. Department of Nephrology, Herlev Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Sabina Chaudhary Hauge & Ditte Hansen

  2. Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 5000, Odense C, Denmark

    Morten Frost

  3. Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark

    Ditte Hansen

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  1. Sabina Chaudhary Hauge
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  2. Morten Frost
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  3. Ditte Hansen
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The literature search and the draft of the review was performed by Sabina Chaudhary Hauge, the work was revised by Morten Frost and Ditte Hansen. All three approved the final paper.

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Correspondence to Sabina Chaudhary Hauge.

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This article is part of the Topical Collection on Bone and Diabetes

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Hauge, S.C., Frost, M. & Hansen, D. Understanding Bone Disease in Patients with Diabetic Kidney Disease: a Narrative Review. Curr Osteoporos Rep 18, 727–736 (2020). https://doi.org/10.1007/s11914-020-00630-2

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