Anitha Rani A, Viswanathan V. Diabetic Foot Infection and Worsening Kidney Function: Implication for Health Care in the Developing World. Int J Diabetol Vasc Dis Res,.
2017;5(5):208-213.
208
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International Journal of Diabetology & Vascular Disease Research (IJDVR)
ISSN:2328-353X
Diabetic Foot Infection and Worsening Kidney Function: Implication for Health Care in the
Developing World
Research Article
Anitha Rani A
1
, Viswanathan V
2*
1
Post Doctoral Research Fellow, Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, Tamil Nadu, India.
2
Head & Chief Diabetologist, M.V. Hospital for Diabetes and President, Prof. M.Viswanathan Diabetes Research Centre, West Madha Church Street,
Royapuram, Chennai, Tamil Nadu, India.
Introduction
Diabetes mellitus (DM) remains one of the most serious
worldwide health challenges. Diabetic foot infection (DFI) and
diabetic nephropathy are the major complications of DM, which
increases morbidity and mortality of patients. Among various
other complications associated with Type 2 Diabetes Mellitus
(T2DM), DFI and its recurrence represents a signiicant and
often challenging clinical problem, which is mainly due to either
diabetic neuropathy and/or peripheral arterial disease (PAD) [1-4].
DFI affects nearly 12 to 25% of patients with T2DM throughout
their lives and it is the leading cause for hospital admission among
diabetic patients in India. This is mainly due to socio-cultural
factors & lack of knowledge on diabetic foot complications [5].
The etiology of DFI is multifactorial and the management of
DFI and its consequences increases the burden on both health
and social services. In developing countries, the common causes
of death after amputation in T2DM patient are infection and
cardiovascular events. Further myocardial infarction was the most
common among post amputated T2DM patient in India [6].
Diabetic foot ulcers and renal function in DM show a strong
correlation between the classiications of diabetic foot ulcer
and eGFR [7]. Indians are at heightened risk for nephropathy,
more than any other ethnic groups and declining of GFR was
also faster. T2DM patients in India are at high risk of developing
Chronic Kidney disease (CKD) and diabetes is now the leading
cause of end stage renal disease (ESRD) in many regions of India
[8]. The burden of CKD among the DM remains to be a global
threat, as the treatment is expensive and lifelong. In developing
Abstract
Background: Diabetic foot infection (DFI) and Chronic Kidney Disease (CKD) are two health care issues causing consider-
able burden in the developing world. The current study was aimed to examine the effect of DFI in declining renal function
among patients with Type 2 Diabetes Mellitus (T2DM).
Methods: A total of 412 patients have been included in a prospective 12 months follow-up study. The study patients were
categorized into Group I: T2DM with CKD and DFI, Group II: T2DM with CKD, Group III: T2DM with DFI and without
CKD and Group IV- T2DM without any complications. Demographic, anthropometric and clinical parameters were recorded
accordingly.
Results: Signiicant fall in eGFR was observed within group I at 6
th
month (p<0.0001) and 12
th
month (p<0.0001). In group
II fall in eGFR was noticed in 3
rd
month (p<0.004); 6
th
month and (p<0.004); 12
th
months (p<0.0001) and in group III signii-
cant fall in eGFR was observed in 3
rd
month (p<0.0001), 6
th
month (p<0.004) and 12 months (p<0.004). No signiicant fall
in eGFR was observed in group IV. The mean differences of eGFR from 0 to 12 months were 11.01, 8.36, 3.52, and 1.2 in all
the groups respectively.
Conclusions: There was a signiicant reduction in eGFR among CKD patients with DFI and DFI patients without CKD.
Therefore development of DFI may cause decline in renal function irrespective of CKD status and preventive steps to prevent
a DFI is mandatory in all T2DM.
Keywords: Diabetic Foot Infection; Chronic Kidney Disease; eGFR; T2DM.
*Corresponding Author:
Vijay Viswanathan,
Head & Chief Diabetologist, M.V. Hospital for Diabetes and President, Prof. M.Viswanathan Diabetes Research Centre, No: 4, West Madha Church Street, Royapuram, Chennai, 600013,
Tamil Nadu, India.
E-mail: drvijay@mvdiabetes.com/researchcommunication@mvdiabetes.com
Received: October 17, 2017
Accepted: November 14, 2017
Published: November 21, 2017
Citation: Anitha Rani A, Viswanathan V. Diabetic Foot Infection and Worsening Kidney Function: Implication for Health Care in the Developing World. Int J Diabetol Vasc Dis Res,.
2017;5(5):208-213. doi: http://dx.doi.org/10.19070/2328-353X-1700042
Copyright: Viswanathan V
©
2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution
and reproduction in any medium, provided the original author and source are credited.