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Related Experiment Videos

Hyperparathyroid bone disease in diabetic renal failure.

T F Cundy1, S Humphreys, P J Watkins

  • 1Diabetic Department, Kings College Hospital, Denmark Hill, London, UK.

Diabetes Research (Edinburgh, Scotland)
|August 1, 1990
PubMed
Summary

Diabetic patients are not protected from hyperparathyroid bone disease in chronic kidney disease. Long-term dialysis and low vitamin D levels contribute to this condition in both diabetic and non-diabetic patients.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Hyperparathyroid bone disease is common in end-stage renal failure (ESRF) patients on haemodialysis.
  • Studies suggested diabetic patients on haemodialysis were protected from this condition.
  • This study investigates mineral metabolism in pre-dialysis patients and long-term haemodialysis outcomes in diabetics.

Purpose of the Study:

  • To assess mineral metabolism and hyperparathyroidism development in pre-dialysis patients.
  • To investigate the long-term incidence of hyperparathyroidism in diabetic patients on haemodialysis.
  • To determine if diabetic patients are uniquely protected against renal osteodystrophy.

Main Methods:

  • Studied biochemical indices of mineral metabolism in 54 pre-dialysis patients.

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  • Analyzed serum parathyroid hormone, calcium, phosphate, and alkaline phosphatase.
  • Performed bone biopsy in five patients with hypocalcaemia and elevated alkaline phosphatase.

    • Main Results:

    • Deteriorating renal function correlated with hypocalcaemia and hyperphosphataemia.
    • Hypocalcaemia strongly linked to elevated alkaline phosphatase, indicating hyperparathyroidism.
    • Long-term haemodialysis ( > 4 years) showed hyperparathyroidism development in a small group of diabetic patients.

    Conclusions:

    • Diabetic patients are not uniquely protected against renal osteodystrophy.
    • Factors like long-term renal failure, low 25-hydroxyvitamin D, and prolonged haemodialysis contribute to bone disease in diabetics.
    • The prevalence of hyperparathyroidism may be lower in diabetics but the underlying mechanisms are similar to non-diabetics.