schemic Type of Diabetic Foot in Patients with and without Chronic Kidney Disease in Assiut University Hospitals: Case Control Study

Tony, Effat Abdelhady; Khalifa, Walla A; Abd Ellah Alawi, Mohamed Hasan Mohamed; Tony, Abeer Abdelhady; Farrag Ahmed, Usra Mohamed

doi:10.21608/jcmrp.2024.279238.1039

schemic Type of Diabetic Foot in Patients with and without Chronic Kidney Disease in Assiut University Hospitals: Case Control Study

Document Type : Original Article

Authors

¹ Internal Medicine and Endocrinology, Internal Medicine Department, Assiut University Hospital, Assiut University, Egypt.

² Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt.

10.21608/jcmrp.2024.279238.1039

Abstract

Abstract:
Background: Despite the significance of these concerns, little is known about the potential relationship between chronic kidney disease and diabetic foot disease.
Aim and Objectives: are to detect ischemic type of foot disease in both diabetic non-CKD patients and diabetic CKD patients, and to assess factors that aggravate ischemic type of foot abnormalities in diabetic CKD patients by measuring serum calcium, phosphorus, potassium, parathyroid hormone, albumin, uric acid, hemoglobin level, and urinary albumin to creatinine ratio.
Patients and Methods: 70 patients were enrolled in this study. Patients were divided into 35 diabetic patients without CKD and 35 diabetic patients with CKD at the Kidney clinic/Nephrology Unit and Centre of diabetes and diabetic foot, Department of Internal Medicine, Assiut University Hospitals, in the period from October 2019 to July 2022. Patients who had other causes of peripheral vascular disease were excluded.
Results: There was a statistically significant increase in the percentage of gangrene and amputation in the diabetic CKD group (31.4%) and (51.4%) when compared with the diabetic non-CKD group (11.4%) (14.3%). Foot ulcers were mainly ischemic and neuroischemic ulcers in diabetic CKD patients (57% of ulcers). In diabetic CKD, there was a significant Positive correlation between ABI and eGFR and a significant Negative correlation between ABI and (Ca, pH, and PTH).
Conclusion: In diabetic CKD patients, ischemic types of diabetic foot (gangrene, amputation, ischemic and neuroischemic ulcer) and PAD were significantly increased when compared with diabetic non-CKD patients. Estimated GFR and serum phosphorus level were the most significant predictors of peripheral arterial disease in diabetic CKD patients.

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