{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:31:55Z","timestamp":1781652715599,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T00:00:00Z","timestamp":1327276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Peripheral arterial disease is common among diabetic patients with renal insufficiency, and most of the diabetic patients with end\u2010stage renal disease (ESRD) have peripheral arterial disease. Ischaemia is probably overrepresented as an etiological factor for a diabetic foot ulcer in this group of patients compared with other diabetic patients. ESRD is a strong risk factor for both ulceration and amputation in diabetic patients. It increases the risk of nonhealing of ulcers and major amputation with an OR of 2.5\u20133.<\/jats:p><jats:p>Renal disease is a more important predictor of poor outcome after revascularizations than commonly expected. Preoperative vascular imaging is also affected by a number of limitations, mostly related to side effects of contrast agents poorly eliminated because of kidney dysfunction. Patients with renal failure have high perioperative morbidity and mortality. Persistent ischaemia, extensive infection, forefoot and heel gangrene, poor run\u2010off, poor cardiac function, and the length of dialysis\u2010dependent renal failure all affect the outcome adversely. Despite dismal overall outcome, recent data indicate that by proper selection, favourable results can be obtained even in ESRD patients, with the majority of studies reporting 1\u2010year limb salvage rates of 65\u201375% after revascularization among survivors. High 1\u2010year mortality of 38% reported in a recent review has to be taken into consideration, though. The preferential use of endovascular\u2010first approach is attractive in this vulnerable multimorbid group of patients, but the evidence for endovascular treatment is very scarce. The need for complete revascularization of the foot may be even more important than in other patients with ischaemic ulcerated diabetic foot because there are a number of factors counteracting healing in these patients. Typically, half of the patients are reported to lose their legs despite open bypass. To control tissue damage and improve chances of ulcer healing, one should understand that early referral to vascular consultation is necessary. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/dmrr.2233","type":"journal-article","created":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T13:37:56Z","timestamp":1327325876000},"page":"40-45","source":"Crossref","is-referenced-by-count":40,"title":["Peripheral arterial disease in diabetic patients with renal insufficiency: a review"],"prefix":"10.1002","volume":"28","author":[{"given":"Mauri","family":"Lep\u00e4ntalo","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Helsinki University Central Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Fiengo","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences University \u2018La Sapienza\u2019  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Biancari","sequence":"additional","affiliation":[{"name":"Department of Surgery Oulu University Hospital  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.09.024"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(97)00003-2"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-010-0128-0"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00420.x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2001.1469"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-1226-2"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl427"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-005-7969-z"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/1056-8727(92)90032-G"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2279-1"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.01.025"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)80267-0"},{"issue":"1","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/0741-5214(93)90007-9","article-title":"Infrainguinal reconstruction for patients with chronic renal insufficiency","volume":"17","author":"Whittemore AD","year":"1993","journal-title":"J Vasc Surg"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200204010-00011"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-005-7970-6"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.09.021"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.06.013"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.09.006"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.11.022"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2312020920"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0720-048X(03)00118-9"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2331031595"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39217.473275.55"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.01.012"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2483071863"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0b013e31815a3407"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2483072093"},{"key":"e_1_2_13_30_1","unstructured":"US Food and Drug Administration.FDA drug safety communication. 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