The Impact of Chronic Kidney Disease on Ulcer-Related Outcomes in Hospitalized Diabetic Foot Ulcers
A Retrospective Study from Thailand
DOI:
https://doi.org/10.15605/jafes.041.01.5197Keywords:
Diabetic Foot Ulcer, Chronic Kidney Disease, ThailandAbstract
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 the 1-year mortality rate after discharge was 11.7%. Advanced CKD (stages 4–5) increased the 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 (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.
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Copyright (c) 2026 Jeeraphan Sripatpong, Sirinate Krittiyawong , Waralee Chatchomchuan , Ekgaluck Wanothayaroj, Taweesak Srikummoon, Poovasit Klinoubol , Phawinpon Chotwanvirat, Siriwan Butadej, Soontaree Nakasatien, Thep Himathongkam, Yotsapon Thewjitcharoen
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