Objective: To study the relationship between renal functional state and the therapeutic effect and prognosis of foot ulcers in the patients with diabetic mellitus.
Methods: The renal function was evaluated in term of glomerular filtration rate, microalbuminuria, proteinuria, blood urea nitrogen (BUN) and creatinine (Cr) levels in 126 patients with I-V class diabetic foot ulcers (according to Wagner classic standard) before the treatment, and then these patients were divided into 1-5 classes (according to Mogenson standard) and given systemic treatment and local debridement, with astragalus for topical application. The time of growth of granulation tissue (GT), the time of healing (HT), the amputation rate and mortality were observed.
Results: GT and HT of ulcer prolonged with worsening of diabetic nephropathy regardless of the disease phase of foot ulcers, especially the GT and HT of foot ulcers were significantly longer in IV and V phases of diabetic nephropathy than those of III phase diabetic nephropathy though the conditions of their foot ulcers were about the same. GT and HT in all the patients with the foot ulcers in the similar condition exhibited significantly positive linear correlation with the severity of diabetic nephropathy (r(1)=2.344 and r(2)=2.563, respectively, both P<0.05). The mortality of I-III phase diabetic nephropathy was significantly lower than that of IV and V phase diabetic nephropathy when the foot ulcers of these patients were of the same extent (P<0.05).
Conclusion: A worsening of renal function would affect the treatment effect and prognosis of foot ulcers in the patients with diabetic foot ulcers, implicating that it is very important to improve the renal function in the treatment of patients with diabetic foot ulcers.