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If a patient has chronic kidney disease and a non-healing wound, how quickly should they schedule a consultation? [Dr. Shams]

Q: If a patient has chronic kidney disease and a non-healing wound, how quickly should they schedule a consultation?

A: They should be seen immediately either by their podiatrist or primary care physician. Usually, these physicians are aware of the vascular disease and can do very simple screening tests to check pulses and Doppler. The Doppler is a signal in the blood vessels in the leg and foot that indicate vascular insufficiency. Patients with vascular insufficiency should be treated right away. Unfortunately, particularly in patients who have chronic kidney disease and diabetes mellitus, lesions can progress rapidly. If they do become infected they can spread to other parts of the foot and may be difficult to treat, especially if they’re not getting enough blood flow. If there’s not enough blood flow to a site, particularly in the toes and the feet, it’s a good medium for bacteria to grow. Even if a small amount of bacteria starts taking hold, it can progress rapidly to a severe situation. I’ve had patients who were completely fine one day and then developed a tiny wound and within a week they developed full gangrene and a black toe.

More videos from the interview with Dr. Shams of the Lower Manhattan Endovascular Center as he outlines why patients with Chronic Kidney Disease are at a greater risk of developing Peripheral Arterial Disease.

Request a consultation at your nearest American Endovascular center today.