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Vascular Calcification, Autonomic Neuropathy, and Peripheral Blood Flow in Patients with Diabetic Nephropathy
Author(s) -
Gilbey S. G.,
Walters H.,
Edmonds M. E.,
Archer A. G.,
Watkins P. J.,
Parsons V.,
Grenfell A.
Publication year - 1989
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1989.tb01136.x
Subject(s) - medicine , peripheral neuropathy , nephropathy , vascular disease , autonomic neuropathy , diabetic nephropathy , cardiology , diabetes mellitus , peripheral , blood flow , endocrinology , biology , cell culture , genetics , neuroblastoma
The possibility that digital gangrene in patients with diabetic nephropathy might be due to abnormalities of peripheral blood flow secondary to vascular calcification has been investigated. Twenty patients with renal failure due to diabetic nephropathy were studied. Peripheral blood flow was measured using venous occlusion plethysmography, together with an assessment of medial arterial calcification on plain radiographs of the hands and feet, and transcutaneous oxygen tension (TcPO 2 ). Hallux blood flow was markedly raised (median 22.5, range 11.5–56.5, ml min −1 100‐ml −1 ) compared with non‐diabetic control subjects (4.7, 1.1–10.5, ml min −1 100‐ml −1 ; p < 0.01) and similar to that in diabetic patients with autonomic neuropathy (29.5, 16.7–49.6, ml min −1 100‐ml −1 ). Although vascular calcification was common and extensive in the patients with diabetic nephropathy, TcPO 2 measurements in the supine foot were normal and did not indicate tissue ischaemia. We conclude that despite extensive vascular calcification high peripheral blood flow occurs in the feet of these patients at rest together with normal transcutaneous oxygen tension.