March 2017

In diabetic neuropathy cases, pedal bone health declines along with renal function

By Jordana Bieze Foster

In patients with diabetic peripheral neuropathy, pedal bone health declines progressively in conjunction with worsening renal function, according to research from Washington University School of Medicine in St. Louis, MO.

The investigators assessed calcaneal bone mineral density (BMD) in 112 patients (43% women) with diabetic neuropathy, and categorized each patient’s renal status based on five stages of chronic kidney disease (CKD), with stage 5 being the most severe. Thirty individuals were classified as stage 1, 35 as stage 2, 31 as stage 3, and 16 as stage 4 or 5.

Mean calcaneal BMD decreased significantly as CKD severity increased; the percentage of participants’ feet classified as osteoporotic increased progressively from 17% of those in stage 1 to 56% of those in stages 4 and 5.

The findings support the need to monitor BMD in this population, said David R. Sinacore, PT, PhD, a professor of physical therapy and director of the Applied Kinesiology Laboratory at the university, who presented the findings in February at the American Physical Therapy Association’s Combined Sections Meeting in San Antonio, TX.


Sinacore DR, Bohnert KL, Bittel DC, Bittel AJ. Pedal bone density in progressive stages of CKD-MBD. J Orthop Sports Phys Ther 2017;47(suppl 1):A26.

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