«ТЯЖЕЛЫЕ ОСЛОЖНЕНИЯ СИНДРОМА ДИАБЕТИЧЕСКОЙ СТОПЫ (ЯЗВА, ГАНГРЕНА, АМПУТАЦИЯ) АССОЦИИРОВАННО С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК. КЛИНИКО- БИОХИМИЧЕСКАЯ ХАРАКТЕРИСТИКА.»
Keywords:
diabetic foot syndrome, chronic kidney disease, hemodialysisAbstract
The purpose of the study is to study the clinical and biochemical characteristics of patients with severe complicated diabetic foot syndrome (DFS, ulcer, gangrene, amputation), associated with chronic kidney disease (CKD)
Material and research methods. 91 patients were examined (prospectively) from type 2 diabetes mellitus (DM2) in the period 2021-2022 in the RSSPMC of Endocrinology named by akad. Ya. Kh. Turakulov, in the department of diabetic foot. All observed patients were divided into 4 groups:
1 gr. -25 patients with DFS, complicated by ulcer, gangrene and amputation, and in combination with CBP 4-5 stages on hemodialysis
2 gr. -25 patients with DFS, complicated by ulcer, gangrene and amputation in combination with CBP 4-5 stages without hemodialysis
3 gr - 20 patients with DFS complicated by gangrene and amputation without CKD.
4 gr - 21 patients with DFS, without severe complications, with the initial stage of CKD.
The control group consisted of 20 patients with DM 2 without complications.
To characterize the examined patients, general clinical, biochemical and instrumental examinations were used.
Research methods -biochemical (bilirubin, direct, indirect, lipid spectrum, ALT, AST, BILD, Coagulogram, blood sugar, glycated hemoglobin, urea, creatinine, SKF, wound pathogens, Procalcitonin, Interlekin -6, VEGF -A and instrumental: ECG, MRI of foots, Dopplerography of the main vessels of the legs, ultrasound of the internal organs, the fundus.
Research results. The highest indicators of glycemia on an empty stomach were observed in patients of group 2, that is, with DFS and CKD 4-5 tbsps without hemodialysis. In this group of patients, reliably lower hemoglobin values were observed (p <0.001), glycated hemoglobin, reliably higher urea, creatinine and SKF (p <0.001). All patients had significantly reduced LDP values (p <0.001) and general cholesterol (p <0.05).
Conclusions. Biochemical indicators were reliably disturbed in patients of group 1, that is, with DFS and CKD 4-5 tbsps for hemodialysis, which indicates the need for further studies in this group of patients.
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