Diabetes, Chronic Kidney Disease, and Vascular Ulcers: Prevention Strategies and Clinical Implications

Background/Aim: Chronic kidney disease (CKD), primarily caused by diabetes, predisposes patients to a high risk of systemic complications, including vascular ulcers. This study aimed to evaluate the impact of arterial vascular ulcers in patients with CKD, with particular attention to predisposing factors including diabetes and prevention strategies. Methods: A narrative literature review was conducted, adopting the Scale for the Assessment of Narrative Review Articles (SANRA), using databases such as PubMed, CINAHL, Embase, and Cochrane Library, along with grey literature sources. Results: The literature review revealed a significant association between peripheral arterial disease (PAD) and CKD, highlighting the prevalence (41.5%) and associated risk factors, such as type 1 diabetes (OR, 2.993; 95% CI: 1.477–6.065, p = 0.002), type 2 diabetes (OR, 2.498; 95% CI: 1.466–4.256, p = 0.001), and hypertension (OR, 1.781; 95% CI: 1.293–2.450, p < 0.001) in hemodialysis patients. Preventive strategies were discussed, emphasizing the automation of ankle–brachial index (ABI) measurement. Conclusions: This review identifies risk factors and preventive strategies for PAD in CKD patients, emphasizing diabetes as a key contributor. Evidence supports current diagnostic approaches and guidelines but highlights the need for larger studies. Standardized protocols and targeted training are crucial for improved management.

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Publication Details

Journal
Diabetology
Published
2025-02-05
DOI
https://doi.org/10.3390/diabetology6020010
Citations
5
Primary Topic
Peripheral Artery Disease Management
Type
article
Field-Weighted Citation Impact
10.03
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article

Diabetes, Chronic Kidney Disease, and Vascular Ulcers: Prevention Strategies and Clinical Implications

Diego Lopane, A. Amendola, Beatrice Mazzoleni, Stefano Mancin et al.
5 citations
Diabetology
Peripheral Artery Disease Management
10.03
article

Diabetes, Chronic Kidney Disease, and Vascular Ulcers: Prevention Strategies and Clinical Implications

Diego Lopane, A. Amendola, Beatrice Mazzoleni, Stefano Mancin, Daniela Cattani, Sara Morales Palomares, Marco Enrico Sguanci, Giovanni Cangelosi, Simone Cosmai, Fabio Petrelli, Alfonso Zarrella, Sarah Scollo
article en
5 citations

Abstract

Background/Aim: Chronic kidney disease (CKD), primarily caused by diabetes, predisposes patients to a high risk of systemic complications, including vascular ulcers. This study aimed to evaluate the impact of arterial vascular ulcers in patients with CKD, with particular attention to predisposing factors including diabetes and prevention strategies. Methods: A narrative literature review was conducted, adopting the Scale for the Assessment of Narrative Review Articles (SANRA), using databases such as PubMed, CINAHL, Embase, and Cochrane Library, along with grey literature sources. Results: The literature review revealed a significant association between peripheral arterial disease (PAD) and CKD, highlighting the prevalence (41.5%) and associated risk factors, such as type 1 diabetes (OR, 2.993; 95% CI: 1.477–6.065, p = 0.002), type 2 diabetes (OR, 2.498; 95% CI: 1.466–4.256, p = 0.001), and hypertension (OR, 1.781; 95% CI: 1.293–2.450, p < 0.001) in hemodialysis patients. Preventive strategies were discussed, emphasizing the automation of ankle–brachial index (ABI) measurement. Conclusions: This review identifies risk factors and preventive strategies for PAD in CKD patients, emphasizing diabetes as a key contributor. Evidence supports current diagnostic approaches and guidelines but highlights the need for larger studies. Standardized protocols and targeted training are crucial for improved management.

DiabetologyVol. 6(2)
Humanitas University (IT), University of Milan (IT), Ospedale Policlinico San Martino (IT), IRCCS Humanitas Research Hospital (IT), University of Calabria (IT)
Openalex Percentile: Top 2%
Peripheral Artery Disease Management
10.03
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