Trusted & Validity:All our courses are developed by a team of authorized U.S. board certified and licensed medical doctors.

Our nationally recognized certificates are signed by authorized board certified U.S. medical doctors.

Nationally Accepted Certification
American Academy of CPR & First Aid, Inc.®

Online CPR Certification Blog

Adynamic Bone disease common in Type 2 Diabetes Patient

Sep
27

Date: September 27th, 2017

Study shows that adynamic bone disease may be meant that you have chronic kidney disease mineral bone disorder CKD-MBD. Adynamic bone disease is the most common form of renal bone abnormality due to reduced synthesis of bone matrix. CKD is a long-term condition where the kidney doesn’t work as it should and CKD-MBD is a condition that accompanies CKD since the kidney is not functioning properly.

Researchers looked into the profile of Chronic kidney disease mineral bone disorder in about seventy patients with type 2 diabetes with newly diagnosed stage 4 or 5 CKD. The patients were not on dialysis and their mean age was 54.2 while 39 percent were female and 61 percent were male.

None of these patients had received treatment that could add minerals or vitamins into their bodies. The researchers established that adynamic bone disease developed when the parathyroid hormone levels were below 70pg/ml in stage 4 CKD while in stage 5 CKD the levels were at 100pg/ml.

Which is more prevalent – high bone turnover disease or low bone turnover disease?

The study also showed that 43 percent of patients with stage 4 CKD and 32 percent of patients with stage 5 CKD experience hyperparathyroidism, which is excessive production of the parathyroid hormone. Parathyroid hormones are supposed to maintain levels of calcium.

When there is excessive production, it removes calcium from the bones making them very weak. The low percentages mean that high bone turnover disease, which leads to bone loss, is not that common in this population. Nearly 40 percent of patients in both groups had biochemical parameters compatible with low bone turnover disease.

Low bone turnover disease is characterized with low osteoblasts, which are used in bone formation. The relatively high percentage means that adynamic bone disease is common in the pre-dialysis CKD population. There is a very low prevalence of high bone turn over disease in the population with diabetes as is seen in the absence of hyperparathyroidism.

Laboratory results on the study

Laboratory results showed that a third of the patients had hypocalcemia, which means they had low levels of calcium of 38.5 percent. This same group had hyperphosphatemia, which means that they had very high levels of phosphate of 31.43 percent.

Patients with stage 5 CKD had iPTH, higher alkaline phosphatase ALP and lower calcium. About 24 percent of patients had a deficiency in vitamin D while about 41 percent had insufficiency in vitamin D. The study found that the proteinuria in type 2 diabetes patients may have also led to low vitamin D.

It was also discovered that patients with osteoporosis, which is a condition where the bones become brittle had higher IPTH levels than those with osteopenia or those with normal bone density. The high rate of iPTH in patients with osteoporosis is what that causes the bones to be brittle since it removes all the calcium from the bones leaving them very weak.

IPTH and total ALP had a linear relationship, proving the ALP as a marker of bone turnover. ALP has always been used to detect liver diseases and bone disorders. IPTH levels alone cannot distinguish adynamic bone disease.

Leave a Reply


+ 5 = 14

Security verified Seal Certified Seal Privacy Seal Business Verified Seal