Clinicians should ‘protect’ renal function of people with diabetic foot ulcer to reduce infection risk, researchers say

Severely reduced estimated glomerular filtration rate (eGFR) is “strongly” associated with poor prognoses in people with diabetic foot osteomyelitis (DFO), a study has highlighted.

The authors of the Chinese study say their findings support the need for healthcare professionals to ensure a person’s renal function is protected in the management of their diabetic foot ulcer.

The team set out to explore the link between (eGFR) and healing/amputation in those with DFO, a moderate to severe infection phase of DFU.

They enrolled 321 inpatients with DFO and were divided into four groups according to their eGFRs: normal (≥90), mildly reduced (60-89), moderately reduced (30-59) and severely reduced (<30).

Participants were followed up for six months to observe outcomes, including ulcer healing and amputation.

Their results demonstrated that severely reduced eGFR was an independent predictor of healing failure in DFO patients, with the study authors saying: “In our study, 23.5 per cent of patients failed to heal, and the healing rate gradually decreased with the decline of eGFR. The present study found that DFO patients who had a severely reduced eGFR (<30 mL/min/1.73 m2) had a high risk for healing failure (OR = 4.72, P = .01).”

They went on to say: “The increased albumin excretion rate could induce peripheral edema, tissue oxygenation and inflammation may be worsened by tissue edema in eGFR-reduced patients.”

The team concluded that severely reduced eGFR in people with DFO was an independent predictor for amputation and healing failure, adding: “The results from this study highlight the need for clinician to protect the renal function in the management of DFU patients.”

The study, led by Bai Chang from Tianjin Key Laboratory of Metabolic Diseases at Tianjin Medical University, has been published in the International Wound Journal.

Share This Post
Have your say!