The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis

Zhang, Jinghang; Chen, Dong; Li, Xuemei; Ding, Min; Xu, Jing; Wang, Meijun; Bai, Chunmei

doi:10.1111/iwj.13765

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…A multicenter study revealed that the diabetic patient with even moderate CKD(eGFR<60ml/min per 1.73m 2 ) had an increased risk for DFU and LEA (51). The eGFR<30ml/min per 1.73m 2 in DFU patients with osteomyelitis was an independent predictor for amputation and healing failure (52). However, in this study, we found the mean eGFR value in the amputated patients was over 60 mL/min per 1.73 m 2 , which was higher than that in the nonamputees.…”

Section: Discussioncontrasting

confidence: 76%

Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers

Gong

Ren

et al. 2023

Front. Endocrinol.

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ObjectivesTo analyze clinical characteristics of the diabetic inpatients with foot ulcers and explore the risk factors of lower extremity amputation (LEA) in West China Hospital of Sichuan University.MethodsA retrospective analysis was performed based on the clinical data of the patients with diabetic foot ulcer (DFU) hospitalized in West China Hospital of Sichuan University from January 1, 2012 to December 31, 2020. The DFU patients were divided into three groups: non-amputation, minor amputation, and major amputation groups. The ordinal logistic regression analysis was used to identify the risk factors for LEA.Results992 diabetic patients (622 males and 370 females) with DFU were hospitalized in the Diabetic Foot Care Center of Sichuan University. Among them, 72 (7.3%) (55 minor amputations and 17 major amputations) cases experienced amputation, and 21(2.1%) refused amputation. Excluding the patients who refused amputation, the mean age and duration of diabetes of and HbA1c the 971 patients with DFU, were 65.1 ± 12.3 years old, 11.1 ± 7.6 years, and 8.6 ± 2.3% respectively. The patients in the major amputation group were older and had longer course of diabetes for a longer period of time than those in the non-amputation and minor amputation groups. Compared with the non-amputation patients (55.1%), more patients with amputation (minor amputation (63.5%) and major amputation (88.2%)) suffered from peripheral arterial disease (P=0.019). The amputated patients had statistically lower hemoglobin, serum albumin and ankle brachial index (ABI), but higher white blood cell, platelet counts, fibrinogen and C-reactive protein levels. The patients with amputation had a higher incidence of osteomyelitis (P = 0.006), foot gangrene (P < 0.001), and a history of prior amputations (P < 0.001) than those without amputation. Furthermore, a history of prior amputation (odds ratio 10.194; 95% CI, 2.646-39.279; P=0.001), foot gangrene (odds ratio 6.466; 95% CI, 1.576-26.539; P=0.010) and ABI (odds ratio 0.791; 95% CI, 0.639-0.980; P = 0.032) were significantly associated with LEAs.ConclusionsThe DFU inpatients with amputation were older with long duration of diabetes, poorly glycemic control, malnutrition, PAD, severe foot ulcers with infection. A history of prior amputation, foot gangrene and a low ABI level were the independent predictors of LEA. Multidisciplinary intervention for DFU is essential to avoid amputation of the diabetic patients with foot ulcer.

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Section: Discussioncontrasting

confidence: 76%

Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers

Gong

Ren

et al. 2023

Front. Endocrinol.

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“…The fumigation and washing method of traditional Chinese medicine are not difficult to operate and have little side effects, so it is worth recommending. 36 patients with grade 0 DF were treated with self-made Huoxue Tongluo foot bath prescription (Wuzao snake, safflower, Chuanxiong, Achyranthes bidentata, Angelica sinensis, chicken blood vine, and clinical addition and subtraction) by Xu Hongtao [ 35 ]. After 8 weeks of treatment, the total effective rate reached 86.…”

Section: Traditional Chinese Medicine Treatment Of Dfmentioning

confidence: 99%

Difficulties in the Treatment of Diabetic Foot and Research Progress of Combination of Traditional Chinese and Western Medicine

Nie

Zhang

2022

Computational and Mathematical Methods in Medicine

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A diabetic foot is any disorder directly attributable to peripheral arterial disease (PAD) and/or the sensory neuropathies influencing the diabetic foot; it is a long-term (or “chronic”) complication of diabetes. Generally, it is a permanent (or “chronic”) comorbidity of diabetes. The swallowing of peripheral neuropathy and peripheral vascular disease leads to damage to the soft tissue, bone, and joint system of the foot. In addition, diabetic feet are also susceptible to infection, which can lead to lameness and even amputation. The management of the diabetic foot can be both challenging and chronic; it may comprise orthoses, surgery, antibacterial medication, and topical dressings. Traditional Chinese medicine (TCM) has a variety of methods for the treatment of diabetic foot with obvious advantages, which can be divided into internal treatment and external treatment of TCM. These treatments include external foot bath, fumigation and washing stains, internal administration of traditional Chinese medicine, syndrome differentiation and staging treatment, empirical prescription, self-made prescription, internal use of proprietary Chinese medicine, massage, acupuncture, and paste powder application, which have significant value in the prevention and treatment of diabetic foot. Some studies have shown that modern medicine combined with herbal therapy can significantly improve the prognosis of diabetic foot. Therefore, this study summarized the difficulties in the therapeutic approaches to diabetic foot and the recent research progress in combining Chinese and Western medicine in the treatment of diabetic foot.

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“…Statistically, patients with PAD or RI had poorer long‐term survival, with more than half of the deaths due to cardiovascular events 44 . RI patients can suffer from peripheral tissue oedema due to an increased rate of urinary albumin excretion, further exacerbating tissue oxidation and inflammatory responses 46 . Also, renal anaemia reduces the oxygen supply to the tissues and hypertension due to kidney diseases can cause endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic‐loaded bone substitutes therapy in the management of the moderate to severe diabetic foot infection: A meta‐analysis

Lin

Peng

et al. 2023

Wound Repair Regeneration

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In recent years, local antibiotic‐loaded bone substitutes (ALBS) have been used increasingly in the treatment of diabetic foot infection (DFI). The meta‐analysis aimed to analyse the efficacy of ALBS on patients with moderate to severe DFI (with or without osteomyelitis). With an appropriate search strategy, 7 studies were selected for analysis (2 RCTs and 5 cohort studies). The result showed that the application of ALBS effectively reduced the length of hospital stay (WMD −5.55; 95% CI: −9.85 to −1.26; P = 0.01), the recurrence rates (RR 0.33; 95% CI: 0.15 to 0.69; P = 0.003) and the mortality rates (RR 0.22; 95% CI: 0.06 to 0.82; P = 0.02). Compared to the control groups, however, there was no difference in healing rates (RR 1.06; 95% CI: 0.96 to 1.18; P = 0.26), healing time (WMD −1.44; 95% CI: −3.37 to −0.49; P = 0.14), the number of debridement (WMD −1.98; 95% CI: −4.08 to 0.12; P = 0.06) and major amputation rates (RR 0.76; 95% CI: 0.35 to 1.61; P = 0.47). The ALBS appears to have some beneficial effects as an adjunct to standard surgery in the treatment of DFI with or without osteomyelitis, as it reduces recurrence rates, mortality rates, and length of hospital stay, but there was no statistically significant difference in enhancing wound healing.

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The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis

Cited by 4 publications

References 34 publications

Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers

Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers

Difficulties in the Treatment of Diabetic Foot and Research Progress of Combination of Traditional Chinese and Western Medicine

Antibiotic‐loaded bone substitutes therapy in the management of the moderate to severe diabetic foot infection: A meta‐analysis

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