Journal of the ASEAN Federation of Endocrine Societies · 2026
The Impact of Chronic Kidney Disease on Ulcer-Related Outcomes in Hospitalized Diabetic Foot Ulcers: A Retrospective Study from Thailand.
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Sripatpong Jeeraphan, Krittiyawong Sirinate, Chatchomchuan Waralee, Wanothayaroj Ekgaluck, Srikummoon Taweesak, Klinoubol Poovasit, Chotwanvirat Phawinpon, Butadej Siriwan, Nakasatien Soontaree, Himathongkam Thep, Thewjitcharoen Yotsapon
Аннотация
OBJECTIVE: To explore the impact of chronic kidney disease (CKD) on hospitalized patients with diabetic foot ulcers (DFU) at a tertiary diabetes center in Thailand.
METHODOLOGY: A retrospective study reviewed hospitalized DFU admissions at Vimut-Theptarin Hospital from 2019 to 2023. Ulcer-related outcomes included complete wound healing at 12 months, major and minor amputations, and 1-year mortality.
RESULTS: A total of 265 DFU admissions from 225 patients were included (male 60.4%; age, 66.7 ± 13.4 years; A1C, 8.2 ± 2.3%, advanced CKD, 26.1%, peripheral arterial disease, 54.7%). Severe DFU (Wagner grade ≥3) comprised 60.0% of all DFUs and almost one-third of patients had prior amputations. Complete healing occurred in 69.8%; major amputation in 4.9%; minor amputation in 30.9%; and 1-year mortality rate after discharge was 11.7%. Advanced CKD (stages 4-5) increased odds of non-healed ulcers (odds ratio OR, 2.69; 95% confidence interval CI, 1.46-4.98; P = 0.002) and 1-year mortality rate (21.7% vs 8.4%; P = 0.004).
CONCLUSION: Advanced chronic kidney disease (CKD) is associated with poorer ulcer-related outcomes in hospitalized patients with diabetic foot ulcers (DFU). Proactive foot care and early referral to multidisciplinary teams, particularly for dialysis-dependent patients, remain essential. Despite ongoing advances in DFU management, these patients continue to face higher rates of non-healing ulcers and mortality, underscoring the need for coordinated inter-institutional care and enhanced public education efforts.
METHODOLOGY: A retrospective study reviewed hospitalized DFU admissions at Vimut-Theptarin Hospital from 2019 to 2023. Ulcer-related outcomes included complete wound healing at 12 months, major and minor amputations, and 1-year mortality.
RESULTS: A total of 265 DFU admissions from 225 patients were included (male 60.4%; age, 66.7 ± 13.4 years; A1C, 8.2 ± 2.3%, advanced CKD, 26.1%, peripheral arterial disease, 54.7%). Severe DFU (Wagner grade ≥3) comprised 60.0% of all DFUs and almost one-third of patients had prior amputations. Complete healing occurred in 69.8%; major amputation in 4.9%; minor amputation in 30.9%; and 1-year mortality rate after discharge was 11.7%. Advanced CKD (stages 4-5) increased odds of non-healed ulcers (odds ratio OR, 2.69; 95% confidence interval CI, 1.46-4.98; P = 0.002) and 1-year mortality rate (21.7% vs 8.4%; P = 0.004).
CONCLUSION: Advanced chronic kidney disease (CKD) is associated with poorer ulcer-related outcomes in hospitalized patients with diabetic foot ulcers (DFU). Proactive foot care and early referral to multidisciplinary teams, particularly for dialysis-dependent patients, remain essential. Despite ongoing advances in DFU management, these patients continue to face higher rates of non-healing ulcers and mortality, underscoring the need for coordinated inter-institutional care and enhanced public education efforts.