Declining Kidney Function Is Associated With Podiatric Risk Among People With Type 2 Diabetes: A Cross-Sectional Observational Study.
Sivashankari Selva Elavarasan, Vijay Viswanathan, Satyavani KumpatlaBackground
Chronic kidney disease (CKD) is related to the development and progression of diabetic foot ulcers (DFU). The aim was to assess the relationship between the International Working Group on Diabetic Foot (IWGDF) podiatric risk (PR) score and kidney function based on KDIGO among people with type 2 diabetes (T2D) in the Indian context.
Materials and Methods
In this cross-sectional observational study, data from 5,972 participants from 2022–2025 were included and categorized based on IWGDF PR and KDIGO categories. Demographic, anthropometric, hemodynamic, biochemical details and comorbidities were recorded.
Results
Proportion of participants in PR stages 0 and 1 across CKD risk categories decreased significantly (56.1%, 30.3% to 13.6% and 51.1%, 32.5% to 16.4%) and in PR stages 2 and 3 increased significantly (27.2%, 28.6% to 44.2% and 18.8%, 19.7% to 61.5% respectively) ( p <0.001). Median eGFR decreased significantly across PR (80 vs. 73 vs. 70 vs. 59; p <0.001). Multivariate logistic regression revealed that age: 50–59 OR (95% CI); [2 (1.7–2.3)], ≥60 [3.7 (3.1–4.4)], longer duration of diabetes: 10-20 [2.1 (1.8–2.4)], >20 [3.2 (2.7–3.9)], smoking [1.4 (1.1–1.7), HbA1c [1.1 (1.1–1.2)], eGFR categories: 60–89 [1.3 (1.1–1.6)], 45–59 [3 (2.3–3.8)], 15–44 [5.5 (3.7–8.3)], albuminuria [1.5 (1.3–1.7)] and insulin usage [1.9 (1.6–2.2]; p <0.001 for all were independently associated with high PR.
Conclusion
Declining kidney function was associated with PR stages of IWGDF.