Naveed Akhtar, Sultan Ahmed, Hassan Mahmood Tabassum, Sadaf Lanjar.
Diabetic foot amputation; frequency of diabetic nephropathy among patients.
Professional Med J Jan ;24(2):302-7.

Introduction: Diabetic foot lesions have remained a major cause of morbidity in patients with kidney failure. Foot complications are more than twofolds in diabetic nephropathy patients, and the rate of amputation is 6 to 10 times higher in diabetic nephropathy patients in comparison to the general diabetic population. Objectives: To determine the frequency of diabetic nephropathy in patients undergoing diabetic foot amputation. Study Design: Observational cross-sectional study. Setting: Surgical Department Unit-II, Sheikh Zayed Medical College and Hospital Rahim Yar khan. Material and Methods: The duration of the study was 2 years from Dec-2013 to Dec-2015. A total number of 73 patients were included in this study. Patients who were admitted to the department of surgery for amputation of the foot or the leg having the history of diabetes regardless of their age and sex were selected for this study. Data analyses were carried out using SPSS Version17 software. Quantitative variables were presented as Mean and standard deviations. Frequency and percentages were computed for qualitative variables. Results: The mean age of the patients was 57.51±7.61 years. Out of 73 cases, there were 43(58.9%) males and 30 (41.1%) females. Previous history of amputation was observed in 26 (35.62%) cases, 48 (65.75%) patients were hypertensive. Out of 73 patients, Forty (54.79%) had controlled diabetes and 33 (45.21%) had uncontrolled diabetes. Twenty seven patients (36.99%) were diagnosed for diabetic nephropathy. The incidence of nephropathy was high in patients with advancing age. This incidence was in 26 (56.62%) patients with age 51 to 60 years and 18 (39.13%) in patients having age more than 60 years. Conclusions: Lower extremity amputations are strongly associated with nephropathy in diabetic patients. It is very important to check and improve the renal function in patients with diabetic foot ulcers who are hypertensive, increasing age and long duration of DM to prevent lower limb amputations.

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