Renal function is highly associated with podiatric risk in diabetic patients.

Autor: Bonnet JB; Diabetes-Nutrition Department, University Hospital of Montpellier, Montpellier, France.; UMR 1302, Institute Desbrest of Epidemiology and Public Health, University Montpellier, INSERM, CHU, Montpellier, France., Szwarc I; Department of Nephrology-Transplantation, University Hospital of Montpellier , Montpellier, France., Avignon A; Diabetes-Nutrition Department, University Hospital of Montpellier, Montpellier, France.; UMR 1302, Institute Desbrest of Epidemiology and Public Health, University Montpellier, INSERM, CHU, Montpellier, France., Jugant S; Nephrocare Montpellier, France., Sultan A; Diabetes-Nutrition Department, University Hospital of Montpellier, Montpellier, France.; PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR, Montpellier, France.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2023 May 11; Vol. 16 (11), pp. 2156-2163. Date of Electronic Publication: 2023 May 11 (Print Publication: 2023).
DOI: 10.1093/ckj/sfad106
Abstrakt: Background: Chronic kidney disease (CKD) is correlated with the incidence of diabetic foot ulcer (DFU). Furthermore, the International Working Group on the Diabetic Foot (IWGDF) has proposed a classification of the risk factors for DFU. The purpose of this study was to investigate the relationship between the IWGDF risk classification and the glomerular filtration rate level estimated by the CKD Epidemiology Collaboration formula (eGFR).
Methods: We conducted a prospective multicentric study. Patients were recruited from either diabetology or nephrology departments. The secondary objectives were to determine this relationship after excluding people on dialysis and to identify the factors associated with podiatric risk.
Results: Four hundred and eighty-six patients were included, with a mean age of 64.2 years (±15.7) and a mean diabetes duration of 15.7 years (±12.1). Based on the IWGDF classification, 53.5% of the population were in podiatric stage 0, 11.7% in stage 1 and 34.8% in stage 2 or 3. The mean eGFR level was significantly lower in patients with podiatric risk ≥2 (36.8 ± 33.9 mL/min/1.73 m 2 vs 71.9 ± 35.3 mL/min/1.73 m 2 , P  < .0001) and a significant association was found between the eGFR and the podiatric risk. This association remained significant after the exclusion of the hemodialysis patients. After receiver operating characteristic analysis, a cutoff of 45 ± 11 mL/min/1.73 m 2 (area under the curve 0.76) was found discriminant to define a group of CKD patients at higher risk for podiatric stage ≥2.
Conclusion: eGFR levels are linked to podiatric stages in diabetes mellitus. Patients with eGFR <45 mL/min/1.73 m 2 and dialysis patients should be carefully managed in collaboration with diabetic foot specialized centers.
Competing Interests: The authors declare that they have no relevant financial interests.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje