Abstract
Background: Diabetes metabolic dysregulation directly or indirectly affects almost all the organs of the body, including renal system, bone mass, and its metabolism. Bone composition and metabolism related to minerals start to change with the onset of chronic kidney disease (CKD). Osteoporosis oftenly coexists with CKD mineral and bone disorder, which is the most common metabolic bone disease resulting in fragility fractures. To design a treatment plan and prevent complications in patients of CKD with low bone mineral density (BMD), understanding the pathophysiology of these two bone disorders is necessary.

Aims and Objectives: The aim is to study the BMD and vitamin D in diabetic patients suffering from CKD and to compare the BMDs among patients with the chronicity of disease.

Materials and Methods: A case–control study was conducted to study the BMD and vitamin D levels among diabetic patients with CKD attending the Medicine and Nephrology Outdoor at M.D.M. Hospital, Jodhpur India. Vitamin D estimation was done by chemiluminescence immunoassay and BMD measured by DEXA scan at lumbar spine L4–L5 for both case and control groups.

Results: Incidence of low BMD and low vitamin D levels is very high in patients suffering from CKD, but it is more profound in patients suffering from diabetes. Majority of them were male and more from rural area. Mean age of patients was 50 ± 8.75 years. Overall 63.34% of CKD patients had low vitamin D level, 36.67% had osteopenia, and 36.67% had osteoporosis. Similarly, 51.62% diabetic patients had osteoporosis, 38.7% had osteopenia, and 83.86% had low vitamin D.

Conclusion: Correlation of vitamin D deficiency with low BMD was statistically highly significant in patients of diabetes with CKD. Early intervention in diabetes patients to prevent low BMD and vitamin D supplements can decrease the complications of low BMD and low vitamin D.

Key words: Chronic Kidney Disease; Diabetes Mellitus; Osteoporosis; Vitamin D; Bone Mineral Density