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-
1.
Wu M, Rementer C, Giachelli CM: Vascular calcification: an update on mechanisms and challenges in treatment. Calcif Tissue Int 93: 365, 2013.
-
2.
Yuan C, Ni L, Zhang C: Vascular calcification: New insights into endothelial cells. Microvasc Res 134: 104105, 2021.
-
3.
Schaper CN, van Netten JJ, Apelqvist J, et al: Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update). Diabetes Metab Res Rev 40: e3657, 2024.
-
4.
Armstrong DG, Boulton AJM, Bus SA: Diabetic foot ulcers and their recurrence. N Engl J Med 376: 2367, 2017.
-
5.
Rocha-Singh KJ, Zeller T, Jaff MR: Peripheral arterial calcification: prevalence, mechanism, detection, and clinical implications. Catheter Cardiovasc Interv 83: E212, 2014.
-
6.
David Smith C, Gavin Bilmen J, Iqbal S, et al: Medial artery calcification as an indicator of diabetic peripheral vascular disease. Foot Ankle Int 29: 185, 2008.
-
7.
Persy V, D'Haese P: Vascular calcification and bone disease: the calcification paradox. Trends Mol Med 15: 405, 2009.
-
8.
Kakani E, Elyamny M, Ayach T, et al: Pathogenesis and management of vascular calcification in CKD and dialysis patients. Semin Dial 32: 553, 2019.
-
9.
Beulens JWJ, Yauw JS, Elders PJM, et al: Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study. Diabetologia 64: 1550, 2021.
-
10.
Zhang Y, Lazzarini PA, McPhail SM, et al: Global disability burdens of diabetes-related lower-extremity complications in 1990 and 2016. Diabetes Care 43: 964, 2020.
-
11.
Eggers PW, Gohdes D, Pugh J: Non-traumatic lower extremity amputations in the Medicare end-stage renal disease population. Kidney International 56: 1524, 1999.
-
12.
Bosco E, Hsueh L, McConeghy KW, et al: Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review. BMC Med Res Methodol 21: 241, 2021.
-
13.
Levey AS, Stevens LA, Schmid CH, et al: A new equation to estimate glomerular filtration rate. Ann Intern Med 150: 604, 2009.
-
14.
National Kidney Foundation: Kidney Disease: The Basics, 2022. Available at: https://www.kidney.org/news/newsroom/fsindex#fast-facts. Accessed October 15, 2023.
-
15.
Jupiter DC, Thorud JC, Buckley CJ, et al: The impact of foot ulceration and amputation on mortality in diabetic patients. I: From ulceration to death, a systematic review. Int Wound J 13: 892, 2016.
-
16.
Gazzaruso C, Gallotti P, Pujia A, et al: Predictors of healing, ulcer recurrence and persistence, amputation and mortality in type 2 diabetic patients with diabetic foot: a 10-year retrospective cohort study. Endocrine 71: 59, 2021.
-
17.
Schmidt BM, Holmes CM: Updates on Diabetic Foot and Charcot Osteopathic Arthropathy. Curr Diab Rep 18: 74, 2018.
-
18.
Rathnayake A, Saboo A, Malabu UH, et al: Lower extremity amputations and long-term outcomes in diabetic foot ulcers: A systematic review. World J Diabetes 11: 391, 2020.
-
19.
Everhart JE, Pettitt DJ, Knowler WC, et al: Medial arterial calcification and its association with mortality and complications of diabetes. Diabetologia 31: 16, 1988.
-
20.
Watkins PJ, Edmonds ME: Sympathetic nerve failure in diabetes. Diabetologia 1983 25: 73, 1983.
-
21.
Edmonds ME: Medial arterial calcification and diabetes mellitus. Z Kardiol 89: 101, 2000.
-
22.
Bonnet JB, Sultan A: Narrative review of the relationship between CKD and diabetic foot ulcer. Kidney Int Rep 7: 381, 2021.
-
23.
Kaur R, Singh R: Mechanistic insights into CKD-MBD-related vascular calcification and its clinical implications. Life Sci 311: 121148, 2022.
-
24.
Durham AL, Speer MY, Scatena M, et al: Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness. Cardiovasc Res 114: 590, 2018.
-
25.
Leskinen Y, Salenius JP, Lehtimäki T, et al: The prevalence of peripheral arterial disease and medial arterial calcification in patients with chronic renal failure: requirements for diagnostics. Am J Kidney Dis 40: 472, 2002.
-
26.
Liu IH, Wu B, Krepkiy V, et al: Pedal arterial calcification score is associated with the risk of major amputation in chronic limb-threatening ischemia. J Vasc Surg 75: 270, 2022.
-
27.
An WS, Son YK, Kim SE, et al: Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease. Int Urol Nephrol 42: 773, 2010.
-
28.
Skolnik J, Weiss R, Meyr AJ, et al: Evaluating the impact of medial arterial calcification on outcomes of infrageniculate endovascular interventions for treatment of diabetic foot ulcers. Vasc Endovascular Surg 55: 382, 2021.
-
29.
Ferraresi R, Ucci A, Pizzuto A, et al: A novel scoring system for small artery disease and medial arterial calcification is strongly associated with major adverse limb events in patients with chronic limb-threatening ischemia. J Endovasc Ther 28: 194, 2021.
-
30.
Yamada S, Giachelli CM: Vascular calcification in CKD-MBD: Roles for phosphate, FGF23, and Klotho. Bone 100: 87, 2017.
-
31.
Toussaint ND, Lau KK, Strauss BJ, et al: Associations between vascular calcification, arterial stiffness and bone mineral density in chronic kidney disease. Nephrol Dial Transplant 23: 586, 2008.
Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot
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Background: We aimed to determine the relative risk of pedal vessel calcification (PVC) on major adverse foot events (MAFEs) and chronic kidney disease (CKD) stage in patients with diabetes mellitus (DM) and peripheral neuropathy (PN).
Methods: We retrospectively reviewed electronic medical records of 152 patients with diagnoses of DM, PN, and CKD stages one to five who had at least one foot radiograph obtained. PVC was scored (from 0–4) based on foot anatomic location and radiology reported MAFEs, which includes foot fracture, Charcot neuroarthropathy, foot ulcer, osteomyelitis, or minor amputation. Risk ratios (RR) with 95% confidence intervals (95% CI) and Poisson regressions were performed assessing the risk of sustaining MAFEs with number of PVCs and stage of CKD.
Results: The risk of any MAFE increased as PVC score increased (RR = 1.23); the risk of any MAFE increased as CKD stage increased (RR = 1.35); and risk of any PVC increased as CKD stage increased (RR = 1.71).
Conclusions: Pedal vessel calcification on a foot radiograph increases the risk of any MAFE and increases with progressive stage of CKD. Pedal vessel calcification may serve as a gateway to prompt investigation, treatment, or referral for at-risk diabetic neuropathic, nephropathic patients.
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