Diabetes, Chronic Kidney Disease, and Vascular Ulcers: Prevention Strategies and Clinical Implications

Background/Aim: Chronic kidney disease (CKD), primarily caused by diabetes, predisposes patients to a high risk of systemic complications, including vascular ulcers. This study aimed to evaluate the impact of arterial vascular ulcers in patients with CKD, with particular attention to predisposing factors including diabetes and prevention strategies. Methods: A narrative literature review was conducted, adopting the Scale for the Assessment of Narrative Review Articles (SANRA), using databases such as PubMed, CINAHL, Embase, and Cochrane Library, along with grey literature sources. Results: The literature review revealed a significant association between peripheral arterial disease (PAD) and CKD, highlighting the prevalence (41.5%) and associated risk factors, such as type 1 diabetes (OR, 2.993; 95% CI: 1.477-6.065, p = 0.002), type 2 diabetes (OR, 2.498; 95% CI: 1.466-4.256, p = 0.001), and hypertension (OR, 1.781; 95% CI: 1.293-2.450, p < 0.001) in hemodialysis patients. Preventive strategies were discussed, emphasizing the automation of ankle-brachial index (ABI) measurement. Conclusions: This review identifies risk factors and preventive strategies for PAD in CKD patients, emphasizing diabetes as a key contributor. Evidence supports current diagnostic approaches and guidelines but highlights the need for larger studies. Standardized protocols and targeted training are crucial for improved management.