糖尿病足患者发生肾脏事件的风险增加:纵向观察研究

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Fadi Alkhami, Sébastien Rubin, Gauthier Borderie, Ninon Foussard, Alice Larroumet, Laurence Blanco, Marie-Amélie Barbet-Massin, Frédéric Domenge, Kamel Mohammedi, Vincent Rigalleau
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引用次数: 0

摘要

目的糖尿病肾病有利于糖尿病足溃疡,但我们不知道是否存在反向关系。我们对 2009 年至 2017 年期间因 2 型糖尿病(T2DM)住院的患者队列进行了回顾性分析,根据国际糖尿病足工作组(IWGDF)的分类,将糖尿病足溃疡风险分为 0 级(无风险)、1 级和 2 级(有风险)以及 3 级(DFD)。我们强调了他们病历中新出现的肾脏事件(终末期肾病或血清肌酐翻倍),直至 2020 年 12 月。结果 在 519 名患者中,142 人(27%)在基线时患有 DFD,159 人(30%)被分为 1 级或 2 级。在 54 ± 27 个月的随访期间,共发生了 36 起肾脏事件:19 人开始透析,1 人接受肾移植,16 人血清肌酐翻倍:DFD 患者和高危患者各发生 15 起,而 0 级 DFD 患者发生 6 起(logrank:P = 0.001)。对以下因素进行调整后,DFD(HR 2.7 至 5.9)和 1-2 级 DFD 风险(HR 2.8 至 5.1)与新的肾脏事件显著相关:i) 年龄和性别;ii) 高血糖暴露;iii) 常规心血管风险因素;iv) 肾脏参数;v) 随访期间新出现的糖尿病足溃疡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
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.
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