*Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC.
†Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC.
J Am Podiatr Med Assoc. 2024 Sep-Oct;114(5). doi: 10.7547/23-233.
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).
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.
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).
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.
我们旨在确定糖尿病（DM）和周围神经病变（PN）患者足部血管钙化（PVC）与主要不良足部事件（MAFEs）和慢性肾脏病（CKD）分期的相对风险。
我们回顾性分析了 152 例诊断为 DM、PN 和 CKD 1 至 5 期的患者的电子病历，这些患者至少有一次足部 X 光片检查。根据足部解剖部位和放射学报告的 MAFEs（包括足部骨折、夏科氏关节病、足部溃疡、骨髓炎或小截肢）对 PVC 进行评分（0-4 分）。采用风险比（RR）和 95%置信区间（95%CI）和泊松回归分析评估了 PVC 数量和 CKD 分期与发生 MAFE 的风险比。
随着 PVC 评分的增加，发生任何 MAFE 的风险增加（RR=1.23）；随着 CKD 分期的增加，发生任何 MAFE 的风险增加（RR=1.35）；随着 CKD 分期的增加，发生任何 PVC 的风险增加（RR=1.71）。
足部 X 光片上的足部血管钙化增加了任何 MAFE 的风险，并且随着 CKD 分期的进展而增加。足部血管钙化可能是促使高危糖尿病神经病变、肾病患者进行及时检查、治疗或转介的一个途径。
