Serum Procalcitonin ,Cystatin C, Kidney Injury Molecule -1 Levels in Patients with Diabetic Foot Ulcer and Relation with Chronic Kidney Disease

Abstract

Objective: To evaluate the serum levels of Procalcitonin (PCT), C-Reactive Protein (CRP), Cystatin C, and Kidney Injury Molecule-1 (KIM-1) in patients with diabetic foot ulcers (DFU). Methods: This case-control study included 120 participants divided into four groups: 30 with diabetic foot ulcers (DFU), 30 with diabetic foot ulcers and chronic kidney disease (DFU & CKD), 30 with diabetes mellitus (DM), and 30 healthy controls. The study was conducted from November 2023 to March 2024. Laboratory tests performed on all patients and controls included CBC, blood urea, serum creatinine, and serum CRP levels using a fully automated analyzer. PCT, Cystatin C, and KIM-1 levels were measured using the ELISA method. Results: The biomarkers PCT, CRP, and WBC showed a significant increase in the diabetic foot group and the diabetic foot with chronic kidney disease group. Additionally, there were positive correlations between PCT and CRP and Cystatin C, and between KIM-1 and Cystatin C. ROC analysis of PCT demonstrated high sensitivity and specificity (91.1% and 99%, respectively). Conclusion: Elevated Procalcitonin levels in diabetic foot patients can predict early infection even without clear clinical signs. Increased levels of Cystatin C and KIM-1 serve as good biomarkers for renal function and complications of diabetes, showing a close relationship with diabetic foot conditions.