Purpose of the Study: explore biochemical characteristics of patients with severe complications of diabetic foot syndrome (ulcer, gangrene, amputation) associated with chronic kidney disease.
ResearchMaterial: We examined 91 patients (prospectively) with type 2 diabetes with severe complications in the period 2021-2024 at the RSSPMC of Endocrinology, in the department of diabetic foot. All observed patients were divided into 4 groups: a) 1 gr. -25 patients with DFS complicated by ulcer, gangrene and amputation and in combination with CKD 4-5 stages on hemodialysis b) 2 gr. -25 patients with DFS complicated by ulcer, gangrene and amputation in combination with CKD stages 4-5 without hemodialysis c) 3 gr -20 patients with DFS complicated by gangrene and amputation without CKD. d) 4 gr -21 patients with DFS, without severe complications, with the initial stage of CKD.The control group consisted of 20 healthy individuals.Research Methods: Biochemical (bilirubin, direct, indirect, lipid spectrum, ALT, AST, PTI, coagulogram, blood sugar, glycated hemoglobin, urea, creatinine, GFR, wound pathogens, procalcitonin, interleukin-6, vascular endothelial growth factorVEGF-A and instrumental: ECG, MRI of the feet, Diplography of the main vessels of the legs, ultrasound of the internal organs, the fundus.
Research Results:The highest rates of fasting glycemia were observed in patients of group 2, that is, with DFS and CKD 4-5 stages without hemodialysis. Significantly lower hemoglobin values were also observed in this group of patients (p<0.001), glycated hemoglobin significantly higher values of urea, creatinine and GFR (p<0.001). All patients had significantly reduced values of HDL (p<0.001) and total cholesterol (p<0.05).
Conclusion:Biochemical parameters were significantly impaired in patients of group 1, that is, with DFS and CKD 4-5 stages on hemodialysis, which indicates the need for further research in this group of patients.