Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Diabetes Care. 2008 Jul;31(7):1331-6. doi: 10.2337/dc07-2244. Epub 2008 Apr 4.

Association between renal failure and foot ulcer or lower-extremity amputation in patients with diabetes.

Author information

  • 1Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. margo@mail.med.upenn.edu

Abstract

OBJECTIVE:

The objective of this study was to evaluate the association between foot ulcers (DFU) and lower-extremity amputation (LEA) and chronic kidney disease (CKD) in patients with diabetes. RESARCH DESIGN AND METHODS: This was a retrospective cohort study of individuals enrolled between 2002 and 2006 who were aged > or =35 years, had a history of diabetes, and were cared for in general practice. The physicians participated in The Health Information Network of the U.K.

RESULTS:

The presence of DFU or LEA and estimated glomerular filtration rate (eGFR) were evaluated in 90,617 individuals with a median time of observation of 2.4 years. Of these individuals 378 had an LEA and 2,619 had a DFU. CKD (eGFR <60 ml/min per 1.73 m(2)) was noted in 23,350 (26%) individuals in our cohort. For the development of DFU compared with our reference group (group 1 [eGFR > or =60 ml/min per 1.73 m(2)]), the hazard ratio (HR) for group 2 (eGFR > or =30 and <60 ml/min per 1.73 m(2)) was 1.85 (95% CI 1.71-2.01) and for group 3 (eGFR <30 ml/min per 1.73 m(2)) was 3.92 (3.23-4.75) (all P < 0.001). For LEA, the HR for group 2 was 2.08 (1.68-2.58) and for group 3 was 7.71 (5.29-11.26) (all P < 0.001).

CONCLUSIONS:

In this observational study, there is a strong association between stage of CKD and DFU or LEA that is probably not just related to the presence of peripheral arterial disease. Individuals with even moderate CKD (eGFR <60 ml/min per 1.73 m(2)) have an increased risk for DFU and LEA.

PMID:
18390800
[PubMed - indexed for MEDLINE]
PMCID:
PMC2453658
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk