Diabetics with chronic kidney disease were less likely to benefit from surgical revascularisation of ulcerated feet.

Diabetic foot ulcer

This observational cohort study looked at whether having chronic kidney disease (CKD) predicts outcome of revascularisation of ulcerated feet in a cohort of patients undergoing treatment at a vascular surgery unit in Finland.

Clinical question:

In people with diabetes and ulcerated foot, does CKD predict the outcome of surgical revascularisation?

The evidence:

The researchers collated data from  a cohort of 597 patients who had 732 revascularisation procedures.

They found that people with more severe chronic kidney disease had a greater risk of amputation than people with less severe or no CKD.  Other factors were also important, however, including the position and type of revascularisation procedure, pulmonary disease and gangrene.

Appraisal hints

Users of this research should consider:

  • Whether enough participants were included in the study.
  • How participants were selected and whether this was consecutive.
  • Were the participants recruited at an equivalent stage of ulceration?
  • Was everyone followed-up consistently?
  • Were outcomes and CKD status adequately defined?
  • The significance of other prognostic factors identified in this study and elsewhere.


Venermo M, Biancari F et al. The role of chronic kidney disease as a predictor of outcome after revascularisation of the ulcerated diabetic foot. Diabetologia. 2011 Dec;54(12):2971-7. Epub 2011 Aug 16.

See also

Recent posts about diabetes complications, including foot ulcers, revascularisation and risk of amputation.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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