| Theme | Forefront of Diabetic Nephropathy | |
|---|---|---|
| Title | Bone and calcium disorder in ESRD patients undergoing regular dialysis due to diabetic nephropathy | |
| Publish Date | 2001/01 | |
| Author | Yasushi Otsuka | Department of Internal Medicine, Division of Nephrology and Hypertension, Jikei University School of Medicine |
| Author | Takashi Shigematsu | Division of Nephrology and Dialysis Unit, Department of Internal Medicine, Sakura National Hospital |
| [ Summary ] | Epidemiological study showed a higher frequency of low PTH/low turnover bone in ESRD patients due to diabetic nephropathy, as compared with other renal diseases. This situation also induced low bone mineral like primary osteoporosis. A reduction of insulin, hyperglycemic effects, the generation of advanced glycation endproducts, and diabetic complications, such as arteriosclerosis, could explain the mechanism by which bone loss and bone turnover suppression occurs in diabetic dialysis patients. Osteoblast response to PTH is suppressed in ESRD patients due to diabetic nephropathy. These phenomena are called "skeletal resistance to PTH". The pathophygiology is still obscure. Further investigation is required to clarify this. | |