N. Esparza

Pie diabético e insuficiencia renal: De la teoría a la práctica

cided to perform a retrospective review of the level of compliance with consensus documents on secondary prevention in patients with diabetic foot at their first hospital examination. We assessed a total of 129 patients, collecting clinical information, haemogram and biochemical test results, and treatments administered. We performed all statistical analyses using SPSS statistical software version 15.0. Of the 129 patients studied, 80 were male and 49 were female, with a mean age of 63.02±13.49 years. The clinical parameters measured revealed arterial hypertension in 71.3% of patients, 23.3% were active smokers, mean HbA 1c was 8.74±2.23%, mean LDL cholesterol was 90.06±35.58mg/dl, and mean triglycerides were 151.84±82.49mg/dl. As regards treatment, 64.3% received insulin and 43.4% oral anti-diabetic drugs. In addition, 52.7% of patients received statins, 1.6% fibrates, 13.2% allopurinol, 21.7% calcium antagonists, 38.8% diuretics, 14.7% beta blockers, 24.8% angiotensinconverting enzyme (ACE) inhibitors, 30.2% angiotensin receptor blockers (ARB), and 55.8% anti-platelet drugs. Thirty-one patients (24%) had a MDRD4<60ml/min. As compared to patients with an MDRD-4>60ml/min, this group was older (70.52±10.87 years vs 60.04±12.64 years; P=.000), had lower levels of Hb (10.62±1.79g/dl vs 12.33±1.96g/dl; P=.000) and haematocrit (31.71±5.77% vs 36.04±5.46%; P=.001), and had higher levels of K+ (4.77±0.56mmol/l vs 4.52±0.39mmol/l; P=.027), uric acid (6.86±2.16mg/dl vs 4.67±1.18mg/dl; P=.000), and red blood cell distribution width (RDW) (16.93±3.75% vs 14.16±2.53%; P=.000), with no differences based on the treatments administered. Based on these results, we can conclude that patients with diabetic foot that seek their first hospital evaluation have hypertension, poorly controlled high glucose levels, and are receiving treatments that are quite different from those recommended for secondary prevention. We must point out that approximately 20% of patients in our study also had chronic renal failure, and there were no significant differences in terms of treatment administered beTais Pérez-Domínguez, Armando Rodríguez-Pérez, Miguel A. García-Bello, Nisa Buset-Ríos, Francisco Rodríguez-Esparragón, Yanet Parodis-López, José C. Rodríguez-Pérez, HIRICARE*