February 21, 2025

Kidney function decline in youth with T1D is associated with bone density loss

A seven-year study monitoring youth with diabetic kidney disease shows that kidney function decline over time is associated with a small risk of more porous bones.  

People with type 1 diabetes (T1D) are two to four times more likely to experience fractures than the general population, and this risk is higher if kidney disease is present. Dr. Funmbi Babalola and colleagues sought to better understand this phenomenon by analyzing bone imaging data collected from 99 youth with diabetic kidney disease between 2016 and 2022. They analyzed each study participant’s bone structure in detail, including the diameter of naturally occurring holes in bones (similar to the texture of sponges), known as bone porosity, as well as many different biomarkers associated with bone health. 

The results show that diabetic youth who experienced a decline in kidney function (as measured by eGFR) did not have significantly different biomarkers for bone health compared to the youth without kidney function decline. However, the youth who experienced kidney function decline did have higher cortical porosity diameter, where the pores in their bones were five per cent larger in diameter than those of non-decliners. The researchers say further research is needed to understand the underlying reasons for this decline in bone density, but in the meantime, they emphasize the importance of optimal glycemic and blood pressure control, maintaining a healthy lifestyle with weight bearing physical activity, and appropriate dietary calcium and vitamin D intake in people with T1D.