HEFT Repository

Foot insensitivity is associated with renal function decline in patients with type 2 diabetes: a cohort study.

Altaf, Quratul A and Sadiqi, Hamed and Piya, Milan K and Tahrani, Abd A (2016) Foot insensitivity is associated with renal function decline in patients with type 2 diabetes: a cohort study. BMC endocrine disorders, 16 (1). p. 64. ISSN 1472-6823.

[img]
Preview
Text (PDF format)
Foot insensitivity is associated with renal function decline in patients with type 2 diabetes a cohort study.pdf - Published Version
Available under License Creative Commons Attribution.

Download (326kB) | Preview
Official URL: https://bmcendocrdisord.biomedcentral.com/articles...

Abstract

BACKGROUND

Identifying patients with diabetes at increased risk of chronic kidney disease (CKD) is essential to prevent/slow the progression to end-stage renal disease (ESRD). CKD and diabetic peripheral neuropathy (DPN) share common mechanisms. Hence, we aimed to examine the relationship between foot insensitivity and CKD in patients with Type 2 diabetes.

METHODS

A prospective observational cohort study in adults with Type 2 diabetes. Patients with ESRD were excluded. Foot insensitivity was assessed using the 10-g monofilament test. Renal function was assessed using estimated glomerular filtration rate (eGFR) based on the MDRD equation. Albuminuria was defined as the presence of urinary albumin/creatinine ratio (ACR) >3.4 mg/mmol.

RESULTS

Two hundred and twenty eight patients were recruited and followed-up for 2.5 years. One hundred and ninety patients (83.4%) had eGFR ≥ 60 ml/min/1.73 m(2). Seventy six (33.3%) patients had foot insensitivity (i.e. abnormal monofilament test). Patients with foot insensitivity had lower eGFR and higher prevalence of albuminuria compared to patients with normal monofilament test. After adjustment for age, gender, ethnicity, diabetes duration, HbA1c, body mass index, insulin treatment, number of anti-hypertensives, history of peripheral vascular disease, and baseline eGFR (R(2) 0.87), baseline foot insensitivity was associated with study-end eGFR (B = -3.551, p = 0.036).

CONCLUSIONS

Patients with Type 2 diabetes and foot insensitivity are at increased risk of eGFR decline. Identifying these patients offers an opportunity to intensify metabolic and blood pressure control to prevent/retard the development of CKD. Future studies of larger sample size and longer follow up from multiple centres are needed to assess the diagnostic performance of our findings in predicting CKD development, and to compare the performance of the monofilament test with albuminuria.

Item Type: Article
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Diabetes
Related URLs:
Depositing User: Preeti Puligari
Date Deposited: 13 Jan 2017 16:20
Last Modified: 13 Jan 2017 16:20
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1116

Actions (login required)

View Item View Item