Yang J, Huang J, Wei S, et al. - According to this observational retrospective study, the urine albumin-creatinine ratio (UACR) level is associated with all-cause mortality, major cardiovascular adverse events (MACE), and mixed endpoint events in patients with diabetic foot osteomyelitis (DFO), and elevated UACR levels increase the risk of all-cause mortality, MACE, and mixed endpoint events.

• In total, 202 DFO inpatients were eligible to participate in the study.

• The average age was 60.3 years, 62.9% were male, and 45.05% tested positive for urinary protein.

• Patients with DFO had significantly higher rates of all-cause mortality, MACE, and mixed endpoint events due to elevated UACR.

• After controlling for confounders, the risk of all-cause mortality, MACE, and mixed endpoint events increased by 81.8%, 135.4% and 136.4%, respectively, in the microalbuminuria group compared with the normoalbuminuria group.

• The risk of all-cause mortality, MACE, and mixed endpoint events increased by 246.2%, 145.1%, and 252.3%, respectively, in the macroalbuminuria group.

• The population attributable risk percentage (PAR%) suggested that the elevated UACR could be responsible for 50.16% of all-cause mortality, 47.85% of MACE, and 59.11% of mixed endpoint events.

• Meanwhile, those with microalbuminuria or macroalbuminuria have lower apoA1 and ABI, higher SCr, and a higher incidence of CHD, hindfoot infection, and severe infection when compared with those with normoalbuminuria.