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Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot

Michael A Jones1, Garrett S Bullock1, Meghan M Crowfoot2

  • 1*Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC.

Journal of the American Podiatric Medical Association
|October 8, 2024
PubMed

Insights

Pedal vessel calcification (PVC) in diabetic patients with peripheral neuropathy increases the risk of major adverse foot events (MAFEs). The risk of MAFEs and PVC also rises with chronic kidney disease (CKD) stage.

Area of Science:

  • Vascular calcification research
  • Diabetic complications
  • Nephrology

Background:

  • Diabetic patients with peripheral neuropathy face risks of major adverse foot events (MAFEs).
  • Chronic kidney disease (CKD) is common in diabetic patients.
  • The interplay between pedal vessel calcification (PVC), MAFEs, and CKD stage requires investigation.

Purpose of the Study:

  • To determine the relative risk of pedal vessel calcification (PVC) on major adverse foot events (MAFEs).
  • To assess the association between PVC and chronic kidney disease (CKD) stage.
  • To evaluate these risks in patients with diabetes mellitus (DM) and peripheral neuropathy (PN).

Main Methods:

  • Retrospective review of 152 patients with DM, PN, and CKD stages 1-5.
  • Pedal vessel calcification (PVC) scored (0-4) from foot radiographs.
  • Risk ratios (RR) and Poisson regressions assessed MAFEs risk with PVC score and CKD stage.

Main Results:

  • The risk of any MAFE increased with higher PVC scores (RR=1.23).
  • The risk of any MAFE increased with progressive CKD stage (RR=1.35).
  • The risk of any PVC increased with progressive CKD stage (RR=1.71).

Conclusions:

  • Pedal vessel calcification on foot radiographs is linked to increased MAFE risk.
  • Both MAFE and PVC risks escalate with advancing CKD stages.
  • PVC may indicate a need for intensified monitoring and treatment in at-risk diabetic patients.
Abstract

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