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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

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Chronic kidney disease and the foot in diabetes--is inflammation the missing link?

F L Game1, N M Selby, C W McIntyre

  • 1Department of Diabetes, Derby Hospitals NHS Trust, Derby, UK. fgame@futu.co.uk

Nephron. Clinical Practice
|June 12, 2013
PubMed

Insights

Diabetic kidney disease (CKD) increases risks for foot disease and amputation. This study explores if foot ulcers may also worsen or cause CKD through inflammation and sepsis.

Area of Science:

  • Nephrology
  • Diabetology
  • Vascular Surgery

Background:

  • Diabetes mellitus frequently leads to chronic kidney disease (CKD).
  • Diabetic foot disease is also common and associated with increased risks in CKD patients, especially those on renal replacement therapy.
  • The heightened risk of foot disease in CKD patients may begin before end-stage renal disease necessitates renal replacement therapy.

Purpose of the Study:

  • To investigate the bidirectional relationship between diabetic foot disease and chronic kidney disease.
  • To explore the potential contribution of foot ulcers to the development or progression of CKD.

Main Methods:

  • This study is a discussion and review of existing literature and proposed mechanisms.
  • It examines the impact of dialysis on tissue hypoxia in CKD patients.
  • It considers the role of sepsis and chronic inflammation from foot ulcers in CKD progression.

Main Results:

  • Patients with CKD have a significantly higher risk of developing diabetic foot disease and undergoing major amputation.
  • The risk for foot disease appears to increase even before patients require renal replacement therapy.
  • Foot ulcers may contribute to CKD development or progression via recurrent sepsis or chronic inflammation.

Conclusions:

  • The interplay between diabetic foot disease and CKD is complex and warrants further investigation.
  • Foot ulcers could be an independent risk factor for CKD progression.
  • Understanding this relationship may lead to improved management strategies for diabetic patients with kidney disease.

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