Risk factors for diabetic foot in maintenance hemodialysis patients with diabetic kidney disease

HUANG Jia-mei; SONG Li; HU Yu-hang; FENG Zhong-lin; CUI Dong-mei; ZHAO Li-yan; ZHANG Qiao-min; YIN Yan

doi:10.13820/j.cnki.gdyx.20251690

Abstract：Objective To investigate the risk factors for diabetic foot(DF)in maintenance hemodialysis patients with diabetic kidney disease(DKD),providing guidance for early detection and intervention in clinical practice.Meth-ods A retrospective analysis was conducted on 95 DKD patients undergoing maintenance hemodialysis from January 2021 to September 2023 at a tertiary hospital dialysis center in Guangdong Province.Patients were divided into DF group(n=19)and non-DF group(n=76)based on the presence of diabetic foot.Clinical data including duration of diabetes,body mass index(BMI),C-reactive protein(CRP),serum creatinine,dialysis vintage,glycated hemoglobin(HbA1c),routine blood tests,pre-dialysis urea nitrogen,urea clearance(KT/V),and presence of lower limb arterial stenosis were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for DF.Results Among 95 DKD patients on hemodialysis,19(20％)had diabetic foot.Univariate analysis showed that the DF group had higher HbA1c and CRP levels and a higher proportion of patients with lower limb arterial stenosis com-pared to the non-DF group.Multivariate logistic regression analysis revealed that elevated CRP level(OR=1.081)and presence of lower limb arterial stenosis(OR=4.885)were independent risk factors for diabetic foot in DKD patients on hemodialysis(both P＜0.05).Conclusion In this cohort,the incidence of diabetic foot in DKD patients on mainte-nance hemodialysis was 20％.High CRP levels and concomitant lower limb arterial stenosis are independent risk factors for diabetic foot.Clinicians should closely monitor CRP levels and lower limb arterial disease in these patients to imple-ment early interventions and reduce the occurrence of diabetic foot.