DIABETIC FOOT AMPUTATION;

FREQUENCY OF DIABETIC NEPHROPATHY AMONG PATIENTS

Abstract

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.