Associationbetweenrenalfunctionandprognosisinpatientswithdiabeticfootulcer

Abstract:

Objective：Toinvestigatetheclinicalcharacteristicsofpatientswithdiabeticfootulcers（DFUs）indifferentstatusofrenalfunction，andtoexploretheassociationbetweenrenalfunctionandprognosis.Methods：Atotalof409patientswithDFUswereretro－spectivelyanalyzed.Accordingtoestimatedglomerularfiltrationrate（eGFR），thepatientsweredividedintothreegroups：normalrenalfunctiongroup，mildrenaldysfunctiongroup，andmoderatetosevererenaldysfunctiongroup.Theclinicalcharacteristics，socio-eco－nomicstatus，self-management，andprognosiswerecomparedbetweenthethreegroups.Aregressionanalysiswasusedtoinvestigatetheassociationbetweenrenalfunctionandprognosisofpatients.Results：Comparedwiththenormalrenalfunctiongroup，therenaldysfunctiongroupshadolderageofpatients，longerdurationofdiabetes，betterself-management，moremicroangiopathyandmacroan－giopathy，andlowerlevelsofhaemoglobinandserumalbumin.Moreover，thepatientswithmoderatetosevererenaldysfunctionhadasignificantlyhigherproportionofindividualswtihadverseoutcomes（43.7%vs.26.8%，χ2=8.567，P=0.003）andasignificantlyhighermortalityrate（26.1%vs.8.3%，χ2=16.587，P=0.001）.UnivariateanalysisshowedasignificantassociationbetweeneGFRandadverseoutcomes（OR=1.462，95%CI=1.132-1.874，P=0.004）.FurtherregressionanalysisconductedindifferentagegroupsshowedthatthedeclineineGFRwasassociatedwithpooreroutcomesofDFUsinelderlypatients（OR=1.614，95%CI=1.021-2.571，P=0.040），butnotinyoungandmiddle-agedpatients.Conclusion：PatientswithDFUshavelongerulcerhealingtimeandhighmortalityratewiththedeteriorationofrenalfunction，especiallyinelderlypatients.