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KMID : 0191120230380210160
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Journal of Korean Medical Science
2023 Volume.38 No. 21 p.160 ~ p.160
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Medial Arterial Calcification and the Risk of Amputation of Diabetic Foot Ulcer in Patients With Diabetic Kidney Disease
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So Joon-Myeong
Park Ji-Ho
Kim Jin-Gyeong
Park Il-Rae
Ha Eun-Yeong
Chung Seung-Min
Moon Jun-Sung
Park Chul-Hyun
Yun Woo-Sung
Kim Tae-Gon
Kim Woong
Park Euy-Hyun
Won Kyu-Chang
Lee Hyoung-Woo
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Abstract
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We assessed the risk factors for major amputation of diabetic foot ulcers (DFUs) in patients with diabetic kidney disease (DKD) stages 3b?5. For DFU assessment, in addition to DFU location and presence of infection, ischemia, and neuropathy, vascular calcification was assessed using the medial arterial calcification (MAC) score. Of 210 patients, 26 (12.4%) underwent major amputations. Only the location and extension of DFU, represented by Texas grade differed between the minor and major amputation groups. However, after adjusting for covariates, ulcer location of mid- or hindfoot (vs. forefoot, odds ratio [OR] = 3.27), Texas grades 2 or 3 (vs. grade 0, OR = 5.78), and severe MAC (vs. no MAC, OR = 4.46) was an independent risk factor for major amputation (all P < 0.05). The current use of antiplatelets was a possible protective factor for major amputations (OR = 0.37, P = 0.055). In conclusion, DFU with severe MAC is associated with major amputation in patients with DKD.
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KEYWORD
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Amputation, Diabetic Foot Ulcer, Diabetic Kidney Disease, Medial Arterial Calcification
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