Diabetic Foot MDT CKD Compound Risk — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateChronic Kidney DiseaseDiabetic Foot MDT CKD Compound RiskESENeph

A 60-year-old man with CKD G3a (eGFR 52 mL/min/1.73m2) and diabetes develops a foot ulcer. He has peripheral neuropathy and absent pedal pulses. His HbA1c is 62 mmol/mol. What is the MOST important multidisciplinary assessment for his foot?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Combined diabetic foot MDT assessment including vascular, podiatry, diabetes, and tissue viability

Diabetic foot disease in CKD carries significantly higher risk of amputation, infection, and mortality compared to diabetic foot without CKD. NICE NG19 (Diabetic Foot Problems) mandates referral to a specialist multidisciplinary diabetic foot team within 24 hours of identifying a foot ulcer. The MDT includes vascular surgery (for revascularisation assessment), podiatry, diabetes specialist, tissue viability, and microbiology. CKD compounds risk through: impaired wound healing, calcific arterial disease (reducing ankle-brachial index reliability), immunosuppression, and altered drug pharmacokinetics. The combined burden of diabetes + CKD + PAD creates a 'perfect storm' for limb-threatening ischaemia.

Reference: NICE 2015 – NG19 Diabetic Foot Problems; KDIGO 2024 – CKD Guideline