Foot Abnormalities in Diabetic CKD Patients

NCT ID: NCT04572945

Last Updated: 2021-03-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

58 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-04-01

Study Completion Date

2022-04-01

Brief Summary

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1. To find the correlation between different stages of CKD and type and severity of foot abnormalities in diabetic patients with CKD.
2. To assess factors that may aggravate foot abnormalities in diabetic patients with CKD by measuring serum calcium, phosphorus, parathyroid hormone, albumin, uric acid…etc.

Detailed Description

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Chronic kidney disease is an important contributor to morbidity and mortality, the global prevalence of CKD was 9.1% (697.5 million cases) in 2017(1). Diabetes is a leading cause of end stage renal disease worldwide. (2) Foot abnormalities and amputation are major health concerns as they diminish health-related quality of life and cause financial burden (3).

KDIGO 2020 defines Chronic Kidney Disease (CKD) as persistently elevated urine albumin excretion (≥30 mg/g \[3mg/mmol\] creatinine), persistently reduced estimated glomerular filtration rate (eGFR \<60 ml/min per 1.73 m2), or both, for greater than 3 months. (4) Diabetic foot is defined as either diabetic peripheral neuropathy, peripheral arterial disease, infection, ulceration, or Charcot osteoarthropathy, or a combination of these abnormalities, in a person diagnosed with diabetes mellitus, according to the guidelines of International Working Group of Diabetic Foot 2020 (IWGDF). (5) There is a much higher incidence of diabetic foot disorder in those with renal disease and outcomes are generally poorer (2) as CKD patients are sharing three main risk factors of foot ulceration and amputation: neuropathy, peripheral arterial disease and increased susceptibility to infection with impaired wound healing. (6)

this research is conducted as little is known about the potential relationship between chronic kidney disease and diabetic foot. This research evaluates the true burden of different diabetic foot lesions in CKD patients, assesses the severity of diabetic foot in different stages of CKD and the factors that may aggravate it in CKD, for future need to modify our clinical policies in management of diabetic foot in CKD patients to provide better prognosis and prevent long term disabilities.

Conditions

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CKD Diabetic Foot

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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1- Cases: Diabetic patients with CKD.

classified according to estimated GFR into 5 stages according to KIDGO 2012 classification.

kidney function test

Intervention Type DIAGNOSTIC_TEST

laboratory and imaging

2- Controls: Diabetic patients without CKD.

defined as patients who have normal kidney function test, normal urine analysis and normal ultrasound findings.

kidney function test

Intervention Type DIAGNOSTIC_TEST

laboratory and imaging

Interventions

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kidney function test

laboratory and imaging

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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HB A1c urine analysis abd us

Eligibility Criteria

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Inclusion Criteria

1. Diabetic CKD patients classified according to estimated GFR into 5 stages according to KIDGO 2012 classification:

Stage 1 CKD: eGFR 90 or Greater Stage 2 CKD: eGFR Between 60 and 89 Stage 3 CKD: eGFR Between 30 and 59 Stage 4 CKD: eGFR Between 15 and 29 Stage 5 CKD: eGFR Less than 15 etheir on dialysis ( satge 5 D) or not (stage 5 non D)
2. Age more than ≥18 years

Exclusion Criteria

1. Patients administer drugs causing neuropathy as:amiodarone, chemotherapy, oxazolidinone linezolid, isoniazid, metronidazole, nitrofurantoin ,immunosuppressants, nucleoside reverse transcriptase inhibitors, levodopa and antifungal drugs.
2. Patients with other causes of CKD.
3. Patients have other causes of PVD.
4. Age less than ˂18 years.
5. Patients' refusal to participate in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Usra Mohamed Farrag Ahmed

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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usra mo farrag, M.B.B.ch

Role: PRINCIPAL_INVESTIGATOR

eygpt

Central Contacts

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Usra mo Farrag, M.B.B.ch

Role: CONTACT

01013460518

Effat ab Toni, Prof.

Role: CONTACT

01097330309

References

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Carney EF. The impact of chronic kidney disease on global health. Nat Rev Nephrol. 2020 May;16(5):251. doi: 10.1038/s41581-020-0268-7. No abstract available.

Reference Type BACKGROUND
PMID: 32144399 (View on PubMed)

Valabhji J. Foot problems in patients with diabetes and chronic kidney disease. J Ren Care. 2012 Feb;38 Suppl 1:99-108. doi: 10.1111/j.1755-6686.2012.00284.x.

Reference Type BACKGROUND
PMID: 22348369 (View on PubMed)

Ndip A, Lavery LA, Boulton AJ. Diabetic foot disease in people with advanced nephropathy and those on renal dialysis. Curr Diab Rep. 2010 Aug;10(4):283-90. doi: 10.1007/s11892-010-0128-0.

Reference Type BACKGROUND
PMID: 20532700 (View on PubMed)

Hammond N, Wang Y, Dimachkie MM, Barohn RJ. Nutritional neuropathies. Neurol Clin. 2013 May;31(2):477-89. doi: 10.1016/j.ncl.2013.02.002.

Reference Type BACKGROUND
PMID: 23642720 (View on PubMed)

Other Identifiers

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Diabetic Foot in CKD patients

Identifier Type: -

Identifier Source: org_study_id

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