Diabetic Foot Infection and Worsening Kidney Function: Implication for Health Care in the Developing World

Background: Diabetic foot infection (DFI) and Chronic Kidney Disease (CKD) are two health care issues causing considerable burden in the developing world. The current study was aimed to examine the effect of DFI in declining renal function among patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 412 patients have been included in a prospective 12 months follow-up study. The study patients were categorized into Group I: T2DM with CKD and DFI, Group II: T2DM with CKD, Group III: T2DM with DFI and without CKD and Group IV- T2DM without any complications. Demographic, anthropometric and clinical parameters were recorded accordingly. Results: Significant fall in eGFR was observed within group I at 6th month (p<0.0001) and 12th month (p<0.0001). In group II fall in eGFR was noticed in 3rd month (p<0.004); 6th month and (p<0.004); 12th months (p<0.0001) and in group III significant fall in eGFR was observed in 3rd month (p<0.0001), 6th month (p<0.004) and 12 months (p<0.004). No significant fall in eGFR was observed in group IV. The mean differences of eGFR from 0 to 12 months were 11.01, 8.36, 3.52, and 1.2 in all the groups respectively. Conclusions: There was a significant reduction in eGFR among CKD patients with DFI and DFI patients without CKD. Therefore development of DFI may cause decline in renal function irrespective of CKD status and preventive steps to prevent a DFI is mandatory in all T2DM.