Fadi Alkhami, Sébastien Rubin, Gauthier Borderie, Ninon Foussard, Alice Larroumet, Laurence Blanco, Marie-Amélie Barbet-Massin, Frédéric Domenge, Kamel Mohammedi, Vincent Rigalleau
{"title":"糖尿病足患者发生肾脏事件的风险增加:纵向观察研究","authors":"Fadi Alkhami, Sébastien Rubin, Gauthier Borderie, Ninon Foussard, Alice Larroumet, Laurence Blanco, Marie-Amélie Barbet-Massin, Frédéric Domenge, Kamel Mohammedi, Vincent Rigalleau","doi":"10.1016/j.diabet.2024.101536","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Diabetic kidney disease favors diabetic foot ulcers, however we do not know whether the reverse relation exists. We investigated whether diabetic foot disease (DFD) related to an increased risk of developing renal events.</p></div><div><h3>Research design and methods</h3><p>We conducted a retrospective analysis of a cohort of patients hospitalized for type 2 diabetes mellitus (T2DM) between 2009 and 2017, stratified for the risk of diabetic foot ulcer grades 0 (no risk), 1 and 2 (at risk), and 3 (DFD) according to the International Work Group on Diabetic Foot (IWGDF) classification. We highlighted new renal events (end-stage renal disease or a doubling of serum creatinine) in their medical records until December 2020. The relationship between DFD and later renal events was analyzed by multivariable Cox regression model.</p></div><div><h3>Results</h3><p>Among 519 patients, 142 (27 %) had a DFD at baseline, and 159 (30 %) were classified as Grades 1 or 2. Thirty-six renal events occurred during the 54 ± 27 months of follow-up: 19 subjects started dialysis, 1 had a renal transplantation, and 16 had a doubling of serum creatinine: 15 each in subjects with DFD and subjects at risk, versus 6 in subjects with Grade 0 DFD (logrank: <em>P</em> = 0.001). Adjusted for <em>i</em>) age and sex; <em>ii</em>) hyperglycemic exposure; <em>iii</em>) conventional cardiovascular risk factors; <em>iv</em>) renal parameters: and <em>v</em>) new diabetic foot ulcers during follow-up, DFD (HR 2.7 to 5.9) and being at risk of DFD Grades 1–2 (HR 2.8 to 5.1) were significantly related to new renal events.</p></div><div><h3>Conclusion</h3><p>The risk of renal events was increased in people with T2DM and DFD.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Increased risk of renal events in people with diabetic foot disease: A longitudinal observational study\",\"authors\":\"Fadi Alkhami, Sébastien Rubin, Gauthier Borderie, Ninon Foussard, Alice Larroumet, Laurence Blanco, Marie-Amélie Barbet-Massin, Frédéric Domenge, Kamel Mohammedi, Vincent Rigalleau\",\"doi\":\"10.1016/j.diabet.2024.101536\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Diabetic kidney disease favors diabetic foot ulcers, however we do not know whether the reverse relation exists. We investigated whether diabetic foot disease (DFD) related to an increased risk of developing renal events.</p></div><div><h3>Research design and methods</h3><p>We conducted a retrospective analysis of a cohort of patients hospitalized for type 2 diabetes mellitus (T2DM) between 2009 and 2017, stratified for the risk of diabetic foot ulcer grades 0 (no risk), 1 and 2 (at risk), and 3 (DFD) according to the International Work Group on Diabetic Foot (IWGDF) classification. We highlighted new renal events (end-stage renal disease or a doubling of serum creatinine) in their medical records until December 2020. The relationship between DFD and later renal events was analyzed by multivariable Cox regression model.</p></div><div><h3>Results</h3><p>Among 519 patients, 142 (27 %) had a DFD at baseline, and 159 (30 %) were classified as Grades 1 or 2. Thirty-six renal events occurred during the 54 ± 27 months of follow-up: 19 subjects started dialysis, 1 had a renal transplantation, and 16 had a doubling of serum creatinine: 15 each in subjects with DFD and subjects at risk, versus 6 in subjects with Grade 0 DFD (logrank: <em>P</em> = 0.001). 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Increased risk of renal events in people with diabetic foot disease: A longitudinal observational study
Objective
Diabetic kidney disease favors diabetic foot ulcers, however we do not know whether the reverse relation exists. We investigated whether diabetic foot disease (DFD) related to an increased risk of developing renal events.
Research design and methods
We conducted a retrospective analysis of a cohort of patients hospitalized for type 2 diabetes mellitus (T2DM) between 2009 and 2017, stratified for the risk of diabetic foot ulcer grades 0 (no risk), 1 and 2 (at risk), and 3 (DFD) according to the International Work Group on Diabetic Foot (IWGDF) classification. We highlighted new renal events (end-stage renal disease or a doubling of serum creatinine) in their medical records until December 2020. The relationship between DFD and later renal events was analyzed by multivariable Cox regression model.
Results
Among 519 patients, 142 (27 %) had a DFD at baseline, and 159 (30 %) were classified as Grades 1 or 2. Thirty-six renal events occurred during the 54 ± 27 months of follow-up: 19 subjects started dialysis, 1 had a renal transplantation, and 16 had a doubling of serum creatinine: 15 each in subjects with DFD and subjects at risk, versus 6 in subjects with Grade 0 DFD (logrank: P = 0.001). Adjusted for i) age and sex; ii) hyperglycemic exposure; iii) conventional cardiovascular risk factors; iv) renal parameters: and v) new diabetic foot ulcers during follow-up, DFD (HR 2.7 to 5.9) and being at risk of DFD Grades 1–2 (HR 2.8 to 5.1) were significantly related to new renal events.
Conclusion
The risk of renal events was increased in people with T2DM and DFD.
期刊介绍:
A high quality scientific journal with an international readership
Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing.
Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.