Correlation Between Amputation of Diabetic Foot and Nephropathy

Introduction. A diabetic foot lesion remains a major cause ofmorbidity in diabetic patients with chronic kidney disease. Westudied the relation between kidney function and the risk ofamputation in patients with diabetic foot.Materials and Methods. We reviewed retrospectively the charts of244 patients admitted to Imam Khomeini Hospital of Sari, Iran, fordiabetic foot from 1996 to 2005. Their clinical characteristics andkidney function indicators, including urine protein excretion andserum creatinine were analyzed and compared between amputeesand nonamputees.Results. There were 244 patients with diabetic foot who wereadmitted to our center during the studied period. The duration ofbeing affected by DM was between 3 months and 34 years (mean,11.80 ± 6.81 years). Sixty-six patients (27.0%) underwent amputation.The amputees were older than the nonamputees (61.1 ± 11.5 yearsversus 55.6 ± 12.5 years, P .001). There were 20 patients (30.3%)in the amputee group and 44 (24.7%) in the nonamputee groupwho had proteinuria (P = .38). The mean creatinine level wassignificantly higher in the amputees compared to the nonamputees(1.78 ± 1.36 mg/dL versus 1.28 ± 1.23 mg/dL, P = .03).Conclusions. Lower extremity amputations in our patients withdiabetic foot were strongly associated with elevated serum creatininelevels. The presence of this complication necessitates intensifyingactions in order to prevent amputations.